Constipation Buprenorphine?

[smilingjane]

Evening health colleagues 😉

I have been taking a 'therapeutic dose of Buprenorphine for 2 years and recently am finding constipation and issue.

Slightly off topic, but just to mention some possibly relevant history, I had a small bowel resection in 2006 which resulted in adhesions.

I am careful not to overeat, and have little appetite and my diet has been poor.

I recently had a 12 hour or so bout of watery diarrhea with accompanying blood. My GP is testing bloods and said internal investigation showed nothing untoward and to go back to see her or A& E if the cramps or blood reappears.

It did over the weekend but wasn't able to reach A&E and I didn't feel ill, no cramp. It was just red blood. Not dark.

Thought I'd wait until Monday and speak to my GP again.

My query is for those out there that take Buprenorphine, do any of you suffer from chronic constipation and if so what do they find most helpfull?

I don't know what causes my issues. It could well be adhesions causing a partial blockage. I do have abdominal adhesions.

It's not necessarily the Buprenorphine causing my constipation. I have had it on and off for many years.

I will see a medic soon. I have CFS/ME and getting out us tricky. However a visit to either the surgery or hospital will happen soon.

Sorry about the length of this.

I have taken Fybergel which worked once. Anyone any ideas? I would be grateful to know what helps people.

Thank you

Jane 😊

[wedgewood]

Constipation is a side effect of that painkiller . I would try to modify my diet as much as possible. Fresh fruit and vegetables. Whole meal bread , Sprinkle flax seeds on porridge etc Use lentils in soups and stews ( not split lentils which have their skin removed ) Keep well hydrated and move around as much as possible to encourage peristalsis. Don’t peel apples . or carrots Eat potato skins .Fibre is the key . Try this before resorting to fibogel etc Drink plenty of water . High fibre diet is also very nutritious and acts as a prebiotic for your Gut Microbiome.

[smilingjane in reply to wedgewood]

Thank you Wedgwood

High fiber can sometimes be an issue for those with partial blockages and,,/or adhesions.

Interesting about the split lentils. I didn't realize this.

I am going to follow your advice. The odd thing is when I've done this in the past it seems to have had an adverse effect.

I will try again.

Could well be liquids. I will def drink more water

😊

[Knittingasweater in reply to wedgewood]

Yes ! a dose of restorelax and Im straightned right away!

[smilingjane in reply to Knittingasweater]

Thank you KnittingsweaterAnother for my list.

I am going to list the different types of laxatives advised so that I can get a handle on how they work. Seems they can have quite different ways of working.

I like the idea of being straightened out right away 😕😊

[smilingjane in reply to wedgewood]

Hi WedgewoodThought I'd post another response to your advice thanking you.

I did indeed increase my daily liquid and chucked all the rubbish out of my cupboards and fridge.

So, a week of regular health smallish meals with a couple of prunes or figs each day, a sachet of Fybergel every other day and all seems fine for the first time in a long time.

I am putting my problems down to a lack of appetite which lead to eating ice cream. Chocolate and porridge. Many days not much else.

So I guess it's not surprising that my body rebelled. I have never really realized how bad sugar can be if you eat it in the form of ice cream or chocolate especially early in the day before proper food.

Thank you again

Xx

[wedgewood in reply to smilingjane]

Really pleased to hear of your improvement smilingjane . All the best to you . 👍👍👍

[smilingjane in reply to wedgewood]

Thank you wedgwood x

[Joolsg]

I'm sorry to hear this.All opioids can cause constipation as they cause dehydration AND gut motility is reduced.

I take Symprove every day. It's one of only 2 probiotics recommended by my daughter's gastro enterologist. Increasing good gut bacteria can really help all manner of stomach & bowel issues.

Also try to add chia or flax seeds to your cereal daily.

And magnesium citrate every night ( I take 2 capsules).

And cauliflower and pears can really help to keep you regular.

My husband swears by sauerkraut and it does seem to help.

[smilingjane in reply to Joolsg]

Thank you Jools. That all seems sound. I think you have responded to a similar post of mine in the past. Sorry to get you to repeat 😮‍💨

[smilingjane in reply to Joolsg]

Just by the by. I know I've said I'm stopping the sweet stuff. What do you all 3 think about prunes and figs?They are helpful but high in sugar?

Is it mainly the fructose to avoid as an ingredient in foods?

Thank you again

😊

[Joolsg in reply to smilingjane]

I eat everything. Fruit does have natural sugar.Why are you giving up fruit?

Figs and prunes (& pears) are great for constipation.

[smilingjane in reply to Joolsg]

Oh I'm not giving up exactly, just being careful about the amount.It was a bowel of ice cream. (After eating nothing else that day), 🙄 I think caused my diarrhea/bleeding maybe inflammation. Not too sure.

[smilingjane in reply to Joolsg]

Pmd you re best source of Symprove 😊

[Thyb]

hi, I have a mixture of diahorrea and Constipation...mainly a bit constipated, have to push hard pellets out.I also have a poor appetite. I have had x 4 Flexible sigmoidoscopy's and a CT Colonoscopy Scan over the past 3-4 Years. I take both Oramorph and Zomorph for pain and both can cause constipation...I had a couple of polyps removed and I have Haemmoroids both internal and external which bleed red blood around 3 times a Week...I also take liquid levothyroxine which can cause loose stools 😳😣....I also have an inguinal hernia and diverticular pouches 😳😳 The foodstuffs others have suggested on here wouldn't do my guts any good plus little appetite and we can't force ourselves to eat....

p.p.s. I have used buprenorphine patches but I don't get on with them hence the Oramorph and Zomorph

After doing some Research sennosides aren't good if we bleed....For both Safety and to be able to go to the toilet I take laxido

[smilingjane in reply to Thyb]

Thank you ThybYou certainly have some awful health issues to contend with

I will steer clear of the sennosides then

I know what you mean about the difficult of forcing ourselves to eat.

I have though since Friday taken to a whole food diet. Including sprouting beans alfalfa etc and saukrout as jools mentioned.

No preservatives no sugar or artificial sweetener. I was scared and that has forced the change in what I eat.

😊

[Thyb in reply to smilingjane]

I can't tolerate chia seeds, no seeds, no nuts, fibre , sauerkraut etc because all aforementioned would cause stomach problems and bleeding for me xx 🤗

[smilingjane in reply to Thyb]

It's good to recognize what you can and can't eat. I'm still working on that but I think I'm close to it. For example I can't digest seeds I have noticed 🤔

[smilingjane in reply to Thyb]

How do you find the Laxaco? Does it provide daily relief? My Fybergel didn't always seem to work ;(

[Thyb in reply to smilingjane]

fybogel, psyllium husk etc no good for my bowel issues plus I have loads of allergies and psyllium can cause gagging oesophagus problems for some. Laxido is on repeat Prescription but you can buy it from any chemists.....It's gentle on the stomach and takes around 6 hours to work...The Maximum I would take is 2 sachets mixed with bottled water in any one Day👌👌🤞🤞♥️

[smilingjane in reply to Thyb]

Interesting, thanks for that 😊

[smilingjane in reply to Thyb]

Thyb. Do you mind me asking what you eat day by day? What's *safe,* for you😊

[Thyb in reply to smilingjane]

I haven't eaten anything at all yet Today, but that's normal for me....I might have toast, beef with a jacket potato but I don't eat the skin on the jacket just the potato...Eggs either fried in kerrygold butter or extra virgin olive oil, bit of Turkey sometimes for protein....I try a tin of light tuna with smashed avocado. I do often get a bit hungry late Evening and have some Green and black's organic Chocolate either 70 or 85% dark chocolate = that Definitely gives me a bowel movement the next Day.....But, I do rely on takeaways as well because I have Multiple Spine fractures so can't cook from scratch Anymore Unfortunately xx 🤗

[smilingjane in reply to Thyb]

Thanks for that The bIt's interesting about chocolate,I was unaware of the laxative effect!

So sorry to hear of your fractures I hope you have adequate pain relief?

Takeaways are so handy and the Internet. I have most of my food delivered. And microwaves .... Brilliant.

I tried figs today. They certainly help!! 😊

[Thyb]

sorry for late replies I have been to Costa for a latte and I do drink far too many milky cups of tea and coffee xx

[smilingjane in reply to Thyb]

As long as it doesn't harm why not? X

[Tildabri]

Pears are the best things I have found to help with regular bowel movements. There are some lovely winter varieties around now that ripen nicely at home, but if not ripe enough I slice them and stew them (skins on) with a dash of cinnamon, a little sweetener (I use date syrup) and a tiny bit of water. I eat them every day, fresh or cooked. I also warm up frozen blueberries and raspberries in the microwave and mix them with natural yoghurt and a bit of pear or banana. I hope you find something that works for you.

[smilingjane in reply to Tildabri]

Thank you YidabriThat sounds a lovely warming idea.

I am definitely going to be doing that.

Gentle and good for our tummies.

Do you have this in the morning or evening,?

Thanks so much again

😊

[Tildabri in reply to smilingjane]

You're welcome! I normally have half a pear with yoghurt and banana at lunch and another half (or some stewed pear) with yoghurt in the evening. (I usually add some sliced almonds and some sultanas to both, because I'm a bit greedy ☺️).

[smilingjane in reply to Tildabri]

Now that sounds like a good 💡

[Yorkie111]

I have just started experiencing constipation with Buprenorphine. Can’t it be controlled by taking laxatives?

Thanks

[smilingjane in reply to Yorkie111]

Hi Yorki111That's exactly what I want to find out.

Different things work for different people.

I'd rather not take laxatives for the rest of my life if I can find the best food option.

😊

[smilingjane in reply to Yorkie111]

Yorkie111I have completely changed my diet and my tummy is thanking me.

See Wedgwoods response above. And the rest. People hav given sound advice.

And plenty of liquids.

Hope you get sorted

X

[Yorkie111 in reply to smilingjane]

I’m trying but it sure is hard. I’ve always eaten a lot of vegs and fruits but maybe the wrong kinds. I just have to get a routine started. I’m not having luck with laxatives and softeners.

[smilingjane in reply to Yorkie111]

Maybe there's a different kind you can try.I have been drinking a lot of water and have seen an improvement in just a week.

Yes routines can be hard to start. I have been quite surprised at the improvement in just a week 😊

[SoundsMusic]

hi Jane, yes - even on the small dose of 0.1mg buprenorphine that I’m on I would be constipated if I didn’t do the following :-

I take a one capsule supplement every evening around dinner time -Magnesium & B6 (300g mag + 25mg B6) Viridian brand. You need the combination of the 2 as Mag needs Vitamin B6 to be released into the system.

Eat 1 kiwi with the skin on every day

One teaspoon milled chia seeds or flax seeds in a yogurt or over a salad daily

Bowl of homemade vegetable soup every day/other day (for fibre) - I’m not very good with fruit so I focus on fresh veg for fibre

2 litres of water daily - I include decaf tea, herbal tea etc in that 2 litres

[smilingjane in reply to SoundsMusic]

Thanks sound music. Very helpfull.

I take both those vits but didn't know about the B6 and mag interaction. I take a Thorne B complex in the morning.

I will switch that to thr evening.. I usually take my magnesium at bed time on an empty stomach. I must have read that's best somewhere.

I will try your regime.

Thanks again

😊

[SoundsMusic in reply to smilingjane]

To tackle constipation I found I need a minimum of 300mg Magnesium - preferably citrate taken with 25-50mg B6 daily. These can be taken as separate supplements - the Viridian brand are capsules so absorbed more easily. This regime is best to get constipation under control initially because mag citrate on its own is most effective for constipation.

For maintenance then I went in to one capsule - the combination of mag oxide, citrate and glycinate + 25mg B6 that I mentioned in the first post.

[smilingjane in reply to SoundsMusic]

Thank you Sound MusicMine is Magnesium is Glycinate.

I'm a little confused. I thought 🤔

That Mag was either Oxide, Glycinate or Citrate.

I didn't know the three can be in one supplement ?

[SoundsMusic in reply to smilingjane]

Yes - Viridian brand do the combo of oxide, glycine and citrate.

But as I said I would stick with high dose of just Citrate - up to 500-600mgs (with the B6 to activate it) first to sort the constipation.

When it’s under control you could change to the combination of magnesiums for maintenance - or just keep it simple and stay with daily dose of 300mg Citrate with the B6

[smilingjane in reply to SoundsMusic]

Thanks for that.I have a lot of Glycinate left. Do you think I will be okay to use those up?

I was recommended those a year or two back

[SoundsMusic in reply to smilingjane]

My understanding is that Citrate is more effective than Glycinate for constipation.

[smilingjane in reply to SoundsMusic]

Thanks SoundMusicI will change to Citrate

Great advice everyone

Thank you

X

[smilingjane in reply to SoundsMusic]

Hi SoundsMusic

On second thoughts, I will change to Citrate.

Thanks again for your advice x

[SoundsMusic in reply to smilingjane]

👍🏻

[Mazzi76]

I get constipation from taking pregabalin. I discovered that I had a bulge in my colon from straining, obviously not a good thing. I find that magnesium citrate works a treat. I got the info from another website which suggested magnesium citrate for opiate induced constipation, which i gather buprenophine is one. i used to have Intermittent diarrhoea too. My GP attributed the varyingdiarrhoea and constipation to my CFS, but my diarrhoea turned out to be irritation from acidic foods and drinks.

[smilingjane in reply to Mazzi76]

Thank you Mazzi76I am pleased you have found an answer that works for you 🙂

I use Mag Glycinate and not up to researching the difference between your mag, (Citrate) and my mag atm.

My CFS has left me pretty grounded after too much talking and messaging over the weekend ....

Even moving my arms to type. the one I take Doesn't make much difference. It might be the dose should be higher.

I am going to try what Sound Music suggested.

Taking the magnesium in the evening along side B6 - in my case I'm using Thorne B Complex which has B6 in.

I will probs try the Magnesium you take too.

Thanks so much for your advice,/experience. Everybody has been so helpful. I will get the right regime after trial and error.

😊

[Mazzi76 in reply to smilingjane]

My ME is at the low energy end of moderate, so I can certainly empathize with you being affected typing. I have recently acquired a Garmin watch (forerunner 55) that has a body battery, which is related to HRV and stress levels. Using screens causes me to have high stress levels and depletes my body battery at an alarming rate. I kind of knew that because I feel so drained if I stay on my laptop or phone too long, but to have hard evidence of it makes me much more aware and therefore more careful how much time I spend on the internet.Although it was magnesium citrate that was recommended in the info I found about opiate induced constipation, I found that magnesium threonate also helped, but not as much ( I tried the Mg threonate to help with insomnia, but it didn't make any difference to that). It must also depend on how much of the opiate one is taking. I am currently taking 2 x 1480mg of Mg citrate. At least magnesium citrate is not so expensive!I knew my diarrhea was nothing to do with my ME bu t didn't even bother arguing with the doctor. I think it's always worth doing any tests that are offered though. Now that I am getting older, I'm 63, inevitably other things are starting to go wrong with my body!

[smilingjane in reply to Mazzi76]

Thanks for that Mazzie 76The watch sounds interesting. So it gives a warning when you overdo things?

I will def get some citrate and swop from the Glycinate.

Thanks so much again

[SueJohnson in reply to smilingjane]

Magnesium citrate is best for constipation. For those who don't have constipation it can cause diarrhea.

[smilingjane in reply to SueJohnson]

Thanks Sue

[smilingjane in reply to Mazzi76]

Just to add ..... A slight Grrrrr. I do get a little frustrated that when one has a chronic illness that's not really understood. Medics can tend to shove the blame for other symptoms without an obvious answer on to the chronic illness, when really as in your case further investigations are necessary.

Take care and thanks again

X

[Mazzi76]

Update: writing that reply to you did not increase my stress levels at all, so it's just when I'm having to concentrate or having problems logging in etc.

[smilingjane in reply to Mazzi76]

That's good 😊

[DonkeyRose]

Hi Jane. My lovely daughter has CFS, fibro, Hms, Eds, GAD etc. Suffered since age 14. I have fibro, GAD, bipolar, etc. Suffer immensely with constipation and diarrhoea every day too which is now quite debilitating that I am afraid to leave the house. Havnt heard of buprenorphine I must admit. Diet, time of day, place or nothing doesn't stop the emergency situations I am faced with. I can't deal with any medications of any kind anymore as it keeps giving me side effects. My doctor is very supportive of my requests and will do anything to help. We all need this. I am sorry if this doesn't really help. I hope you find some useful information soon and find relief for this debilitating condition. 🤔

[smilingjane in reply to DonkeyRose]

How Donkey rose, so sorry to hear of your situation and your daughter's. Horrible.

It's interesting, I changed my diet a week ago, and started the b6 with the Magnesium , along with adding figs or dates daily.(after the blip) and everything has calmed down. Quite amazing.

Your situation sounds very different to mine

Before I stopped work a few years ago due to severe ME/CFS, I took Imodium daily, just to avert having to use the toilet at work and urgent situations.

I hadn't realized that this wasn't a good idea as I had a bowel resection back in 2006

So, for now it seems I am okay.

I do hope things become easier for you and your daughter.

X

[Goldy700]

I was on Targin for 5 months and now on Buprenorphine patch and Temgesic. I find I am less constipated than i was on Targin. I do find it very helpful to take a scoop of Osmolax or Movicol in a cup of water everyday.

[smilingjane in reply to Goldy700]

Thank you for that goldy 700. I will add that to my list. I seem to be okay at the moment. I changed my diet completely, and with a sachet of Fybegel every other day, things have calmed down.

😀

[toredol]

I've been in pain management since 2006. For chronic narcotic-induced constipation, I've taken Linzess 290 mcg caplets since 2016. For me, this works better than any of the OTC meds I've tried. Hope this gives you another option.

[smilingjane in reply to toredol]

Thank you toredol. Not heard of this . Will research. Thanks so much for responding.😊