BOWEL REGIMEN INFORMATION

CONSTIPATION is the most frequent and most uncomfortable side effect of the long-term use of opioids.  Tolerance to this effect develops slowly.  If untreated, constipation can lead to a bowel obstruction and pain.  With the onset of opioid therapy, laxatives, stool softeners and fluids should be taken to avoid constipation.  Use of laxatives, stool softeners and fluids should be increased as opioid dose or frequency of opioid dosing increases.

The following protocol may be used to prevent or treat constipation:

·        Be sure to drink plenty of fluids

·        Begin taking a stool softener or gentle laxative such as Colace (Docusate Sodium) or Senekot (Senna Concentrate) or Peri-Colace (Casanthranol) two to three times per day.

·        If you have no bowel movement within 48 hours, take 2 to 4 tablespoons of magnesium citrate one to two times per day OR 2 to 3 tablets of Dulcolax (Bisacodyl) 3 times per day OR a nighttime dose of 2 to 3 tablets of Senekot.

·        If you still have no bowel movement by 72 hours, check for impaction.  An impaction may be cleared manually after softening with a glycerin suppository or oil-retention enema, followed by enemas until clear.