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Laxatives and stool softenersThese medications are very important for patients who are on opiate medication. Constipation is one of the most common side effects of opioids. It is the one side effect that patients do not get used to over time. Unfortunately this is a subject that many patients are uncomfortable to bring up during their office visit. The problems with opioids are that they slow down bowel transit. This means that the usual ways of dealing with constipation like making sure that you are well hydrated and eat sufficient amounts of fiber (in fruits and vegetables) may not be sufficient. Often stool softeners may only increase the bulk without providing any forward motion. It is therefore often the case that also a laxative is needed to keep these patients regular. Many patients are able to control constipation with over the counter medications containing senna (natural plant extract), bisacodyl (Dulcolax) or PEG (polyethyleneglycol) 3350 (Miralax). It may take some time and experimentation to come up with the best combination that is effective without causing any cramps or bloating. In severe cases lactulose and even fleet enemas can be used intermittently.
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