Just when you’re getting your pain under control, you have another discomfort to deal with—constipation. One of the most common side effects of taking opioid pain medications like Vicodin, Percocet or codeine is constipation. Research shows that anywhere from 40 to 90% of opioid users at some point experience opioid-induced constipation (OIC). For some people, OIC is a mere inconvenience. For others, it can be extremely painful and difficult to tolerate. But there are many things you can do to help avoid OIC and get your bowels moving in the right direction. What Is Constipation? Constipation is different for everyone. What may be “normal” bowel function for you may be quite different for someone else. You may typically have one or more bowel movements a day, while some people may only go every second or third day. In general, constipation occurs when bowel movements become difficult and cause straining, you have hard or lumpy stools, or you have a sensation of incomplete evacuation. Opioids slow down bowel movements as they make their way through the intestine, causing the stool to become hard and difficult to pass. For some people, this can be so debilitating that they would rather go off their medicine temporarily to get relief, even if they have to suffer with pain. This is not usually recommended because it may not bring relief from the constipation. But there are a few other things you can try: Go regularly. Try to get in the habit of going to the toilet at the same time each day to help “train” your bowels. Make sure you have plenty of comfort and privacy so you don’t feel rushed, and have time to complete the job. The best time may be after a meal. Don’t wait; get up and go. Suppressing the urge to go can make constipation worse, so don’t wait. For example, if you are out at a public event, don’t wait until you get home to go to the bathroom. Eat more fiber. If your diet is deficient in fiber, try to get more fresh, canned or dried fruits, raw vegetables and whole grain breads and cereals in your diet. You can also try prune or pear juice, or add one or two tablespoons of unprocessed bran to your food. It’s important to add fiber only when you’re hungry; don’t force any foods if you’re already full. Drink plenty of water. Some people find this hard to do when they are in pain, but water will help keep your stools soft. Aim for 8 to 10 eight-ounce glasses a day, or as much as you can tolerate. Warm liquids can help the bowels move, so try a warm drink about a half hour before your planned time to use the bathroom. Get moving. Exercise can be difficult when chronic pain is involved, so brainstorm with your doctor about some easier ways to get mobile every day, or at least every other day. Walking helps get the bowels going and is an excellent option—and generally safe and easy—for most people. Try a stool softener or laxative. Doctors often recommend combining a stool softener and laxative to help promote more normal bowel movements. Sometimes a suppository or enema may be necessary to clear the rectum of any impacted stool before starting a softener or laxative. Talk to your doctor before trying any of these treatments. Ask about medication. There are medications available that help decrease the constipating effects of opioids. Some of these may have other side effects, so ask your doctor if these may be right for you. Talk to your doctor about all of your treatment options, and be sure to discuss all of your symptoms, whether they seem minor or they’re interfering with your daily life. Unmanaged chronic constipation can lead to: Anal fissures Rectal pain and bleeding Abdominal pain Abdominal distension hemorrhoids Urinary incontinence Fecal impaction Rectal prolapse In very severe cases, chronic constipation can obstruct the bowels or damage the colon, so it’s important to keep your doctor informed to help avoid any further problems. The sooner you seek treatment for constipation, the easier the road to relief.