10 Signs You May Have Opioid-Induced Constipation

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Jennifer Larson on November 21, 2022
  • constipated-woman-on-toilet
    An Uncomfortable Downside of Opioid Therapy
    Opioid therapy can be a blessing…and a curse. It can knock out some pretty spectacular pain, but it can also incur some pretty uncomfortable side effects. If not at the top of the list, constipation is probably pretty near the top. So, if you’re taking an opioid painkiller, you need to be prepared to recognize and cope with this side effect.
  • Calendar
    1. Infrequent Bowel Movements
    If you are taking opioid painkillers and have fewer than three bowel movements per week, it’s a pretty good bet you’re experiencing constipation as a side effect of the medication. Granted, there’s no standard number of bowel movements you should have, but if you’re only having a couple per week—or the number you usually have has drastically dropped—the opioids are probably at least partially responsible.
  • Public restroom
    2. A Constant Urge to Go
    It seems especially cruel that many people with opioid-induced constipation, or OIC, often experience the uncomfortable sensation of always needing to go to the bathroom, only to be unable to produce once they get there. But it’s not uncommon.
  • close-up-of-mans-belly-and-belt
    3. A Tender Belly
    When you get constipated, you may find yourself reaching for loose clothes that don’t put any extra pressure on your belly—and foregoing that belt or sash. The reason: your abdomen is swollen, bloated and sore as a result of the constipation. You may feel overly full or even gassy.
  • Toilet paper
    4. Elimination Pain
    You’re wincing and straining on the toilet, but you’re all too aware that you’re having trouble. It’s becoming harder and harder to pass anything, and when you do, it hurts.
  • toilet-in-public-restroom
    5. Small, Hard Stools
    When you are able to produce a bowel movement, you’re typically only passing small, hard, dry stools—another common side effect of opioid therapy.
  • hemorrhoid-definition
    6. Hemorrhoids
    An occasional bout with constipation might not be problematic, but chronic constipation can lead to the development of hemorrhoids. When you’re constipated, you often strain hard to pass stools, and that strain can cause veins around your anus and rectum to swell—and sometimes even bleed.
  • Pills
    7. Higher Doses
    If your pain worsens and your doctor decides to increase the dose, the constipation may worsen, too. Unfortunately, this happens all too often, since most people do develop a tolerance to opioids after a while and do require higher doses.
  • Serene man sleeping in bed in the morning
    8. Lethargy and Fatigue
    If you feel sick and tired, not just sick and tired of being constipated, that’s another sign. Some people even feel depressed. It could be a result of dehydration, or perhaps you’re not getting enough nutritional benefit from the foods you eat, since the opioids tend to slow down your digestive system.
  • woman-with-stomachache-on-couch
    9. Nausea
    Opioids do slow down the speed and function of the digestive system, which results in constipation. However, the slow-down can sometimes result in nausea, too. In fact, some experts estimate that it affects about one-quarter of people who take opioids for pain relief. Vomiting and gastric reflux can also develop as the digestive system slows down.
  • patient-with-stomach-problem-in-emergency-room
    10. Bowel Obstruction
    Opioid-induced constipation can definitely cause a lot of discomfort and reduce the quality of life for the people who suffer from it. But a severe case can also cause very serious side effects. A bowel obstruction can even lead to a rupture, which can be dangerous or even fatal. Unfortunately, bulk-forming laxatives, which are a common solution for ordinary constipation, are not recommended for people with OIC, since they can increase your chances of developing a bowel obstruction.
  • Doctor Writing Medical Prescription
    Preventive therapy is available.
    Fortunately, you do have some options that may help prevent constipation from occurring. Your doctor may suggest taking a laxative and stool softener right away, rather than waiting until the constipation develops and begins causing pain and discomfort. And of course, there are treatments available for dealing with constipation after it’s already occurred, too, although people have varying levels of success with them. It’s usually easier to prevent a possible problem than to fix a definite problem!
10 Signs You May Have Opioid-Induced Constipation

About The Author

Jennifer Larson has more than 15 years of professional writing experience with a specialization in healthcare. She has a master’s degree in journalism from the University of Maryland and memberships in the Association of Health Care Journalists, the Society of Professional Journalists, and the Education Writers Association.
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  2. Definition and Facts for Constipation. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/constipation/Pages/def...
  3. Management of Opioid Induced Constipation. UW Health. http://prc.coh.org/pdf/OpioidIndConst9-11.pdf
  4. Managing Side Effects and Complications of Opioid Therapy for Chronic Pain. U.S. Department of Veterans Affairs. http://www.healthquality.va.gov/guidelines/Pain/cot/OpiodManagingSideEffectsFactSheet23May2013v1HiResPrint.pdf
  5. Pain relief, opioids, and constipation. Harvard Health Publications. Harvard Medical School. http://www.health.harvard.edu/pain/pain-relief-opioids-and-constipation
  6. Swegle JM, et al. Management of Common Opioid-Induced Adverse Effects. American Family Physician. 2006 Oct 15;74(8):1347-1354. http://www.aafp.org/afp/2006/1015/p1347.html
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Last Review Date: 2022 Nov 21
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