Opioid sensitivity and gut motility

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Hello everyone

I am about to start my last 9 days of treatment and I am counting down the days like never before! It still seems so far away.

Anyway, I was advised to start taking cocodamol last Thursday having been only using the occasional paracetamol. My nurse said it was vitally important to start medicating for pain now so that I could make it to the end of treatment, and I agreed. So, I started initially taking 2 lots of cocodamol and, almost immediately, my gut went on strike! Unbelievable how little it took. I got worried and reduced the dose to once a day at bedtime as getting constipated is really a very bad idea. I also started on the Movicol and have taken 2 sachets a day for the past two days. This has had little to no effect and visits to the toilet are painful with very hard and small offerings! Typical constipation.

I was looking for advice from anyone who has experienced this. Prior to taking the cocodamol I had quite loose and urgent movements in the morning but I think these were preferable to the alternative. I am evidently very sensitive to opioids, or rather my gut is. I wonder if I simple need to up my Movicol to 3 or maybe more than 3 sachets a day or ask for an alternative, non opioid pain reliever.

I am acutely aware that the last part of the treatment, plus the first couple of weeks after will be the worst. I will need pain relief and I am now worried that I will be in trouble and choosing between being in a lot of pain but being able to poo, or being in less pain until I need to poo and then being in agony 

Any thoughts appreciated.

Many thanks

Jo xx

  • 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