Opioid sensitivity and gut motility

Hello Jo

You are absolutely right, the last thing you want is constipation.  However, if you are in this much pain now then I would say you are definitely going to need opioid drugs to get you through the last stages.  The Movicol can take a couple of days to work, but failing that you could move on to Lactulose which (I believe) is stronger.  When I struggled I also had prune juice regularly in addition to Laxido which made my stools very loose but infinitely better than constipation.  It is also essential that you take whichever stool softeners you need really regularly to avoid any problems which may take a couple of days to sort out.

In your shoes I would take more Movicol, no question.

Very best of luck, remembering what this is like I really feel for you.

Irene xx 

Hi Dahlia68 

So close to the finish line. I can't help re the cocodamol as I only took paracetamol, the full dose each day as advised by my radiotherapy nurse. Keep counting those days. Xx

Hi Bungle1

That is good that you managed without the opioids. I was hoping to do the same but the nurse seemed quite insistent that if I didn't step up the painkillers then I would struggle to cope. I'm keeping them at a minimum but if the constipation continues I will reassess and try just paracetamol and Nurofen.

I guess your pain was tolerable then or you have a high pain threshold? I imagine it depends on where they are targeting the treatment.

I can't wait for it to be over I absolutely hate taking the chemo and painkillers!

Thanks Irene

I may try the prime juice as that sounds like a nice natural option. Normally I eat a very high fiber diet but was advised to keep it low fiber during treatment. I think, along with the drugs, my body is just confused!!

Hopefully things will get moving so to speak.ive upped the Movicol to 3 sachets today and will see how I get on tomorrow.

Hi

They did suggest cocodamol probably about half way through but I wasn't keen on taking it which is when they said to take the maximum paracetamol dose each day so it built up in my system rather than just taking them when I needed them. I wasn't keen on doing that either but thought i better. X

It sounds like you felt very much like I do. I hate taking anything and generally steer clear. The chemo drugs are horrid but I know they are making the radiotherapy more effective, so I'm taking them as directed.

The pain relief is an interesting one as I was coping ok physically, but mentally I was struggling and had a couple of mini breakdowns at the hospital (crying) and I think it was because of these that they encouraged me to adopt a more rigorous pain relief schedule. It has back fires somewhat by giving me constipation, which has upped the pain by making it more uncomfortable to go to the toilet!

Very tough to know what to do now, stick with the cocodamol and take Movicol regularly or revert back and take a more regular dose of paracetamol and see how I am!

Tricky:) 

Its a hard decision but you know you best. Whatever you decide isn't going to affect the outcome of treatment. I had all my chemo intravenously which was maybe easier but I have nothing to compare it to so don't really know. You are correct I'm not keen on taking meds unless no other option. I cried in the face of one of my radiotherapists one day while telling her i was fine other than that I occasionally had a couple of tears in silence while on the table but none of that was from physical pain. Xx

Hi Jo 

Sorry to hear you're going through such a rough time and know just how you feel as I just gone through 192 hours of chemo and 5.5 weeks of radiotherapy, It's been 3 weeks since my last session of radiotherapy and I've been through all the symptoms you are having, diarrhoea chronic constipation, scared to pass wind in case it's not .I'm taking oramorph and Codeine with paracetamol which all cause constipation and trapped wind which is really painful,  I've tried laxatives but nothing agrees with me and on occasions been in a right mess . But what I have found helps is if you feel you need to poo or pass wind take a bucket into the shower with you and set the water temperature to like warm and gently spray the water around your bottom and you will find it helps ease out trapped wind and poo and the pain is minimal. Give it a go it'll change your whole outlook on thing . Hope everything goes OK for you.

Hello Jo I remember the swings of constipation and diarrhoea and was on opioid meds as personally I would have struggled with the pain and paracetamol and ibuprofen was just not enough. I did initially take movicol which did prevent my constipation but it also made me really loose. I was put on a FODMAP diet and very strict about sugars and certain carbohydrates which cause constipation. I read about organic black strap molasses and its benefits for gut health. I took just under a teaspoon in a full glass of hot water before bed. This works as a gentle osmotic laxative due to its magnesium content. It draws water into the intestines to soften and stimulate bowel movements. It is not a laxative it is a stool softener. It also helped me sleep. I am four years post treatment and there are times when I have had to change my strict routine of plenty of vegetables and still worry about constipation due to slight stenosis and drink this before bed. This helps bulk and soften the stool. I only need a teaspoon but for some it’s not enough or too much so you need to experiment. 

Julie

Thank you Stevepainb84f79 

This is a great idea and I will try it for pain relief. I did think about pooping into my sitz bath but this seems more hygienic, sort of like a bidet. I will give it a go as things are getting very sore down there and I need any help I can get.

I hope you are recovering well xx