Narcotic pain medications cause constipation in almost all patients. We usually suggest taking the minimum amount of narcotic needed to help with your pain after spine surgery in order to limit side effects such as constipation.
If you are taking narcotic pain medications regularly after spine surgery we often suggest using over-the-counter medications (OTC) medications to help relieve constipation. You do not need a prescription for these medications. They can be purchased in most pharmacies around town.
Keep in mind that it's important to read and follow the instructions on the product label. Here are some common types of OTC medications for constipation:
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Bulk-Forming Fiber Supplements:
- Examples: Psyllium husk (Metamucil), methylcellulose (Citrucel).
- How They Work: These supplements add bulk to the stool, helping it pass more easily through the digestive tract.
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Stool Softeners:
- Examples: Docusate sodium (Colace), docusate calcium.
- How They Work: Stool softeners help soften the stool by increasing the amount of water it absorbs, making it easier to pass.
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Osmotic Laxatives:
- Examples: Polyethylene glycol (MiraLAX), lactulose.
- How They Work: Osmotic laxatives increase the amount of water in the intestines, softening the stool and promoting bowel movements.
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Stimulant Laxatives:
- Examples: Senna (Senokot), bisacodyl (Dulcolax).
- How They Work: Stimulant laxatives promote bowel movements by irritating the intestines, which stimulates the muscles to contract.
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Lubricant Laxatives:
- Examples: Mineral oil.
- How They Work: Lubricant laxatives coat the stool, making it slippery and easier to pass.
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Combination Products:
- Some OTC medications combine different types of laxatives to provide multiple mechanisms of action. For example, a combination might include a stool softener and a stimulant laxative.
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Enemas and Suppositories:
- Examples: Bisacodyl suppositories.
- How They Work: Enemas and suppositories are inserted into the rectum to stimulate bowel movements. They are generally considered for short-term use.
Always follow the recommended dosage instructions, and if you experience persistent or worsening symptoms, or if you have concerns about using these medications, discuss with your surgeon or PCP.
If you would like to avoid taking additional medications, incorporating certain types of foods into your diet can help promote regular bowel movements and alleviate constipation. Here are some types of foods that are known to have a positive impact on digestion and can help resolve constipation:
1. Fiber-Rich Foods:
- Fiber adds bulk to the stool and helps it move through the digestive tract more easily. Include a variety of high-fiber foods in your diet:
- Whole grains (oats, brown rice, quinoa)
- Bran cereals
- Legumes (beans, lentils)
- Nuts and seeds (flaxseeds, chia seeds)
- Fruits (apples, pears, berries)
- Vegetables (broccoli, carrots, spinach)
2. Prunes and Prune Juice:
- Prunes contain both fiber and natural sugars that have a mild laxative effect. Prune juice is another option if you prefer a liquid form.
3. Water-Rich Fruits:
- Hydration is crucial for softening the stool. Water-rich fruits can contribute to your overall fluid intake:
- Watermelon
- Cucumber
- Oranges and citrus fruits
4. Yogurt with Probiotics:
- Probiotics, which are beneficial bacteria, can help regulate digestion. Yogurt with live and active cultures is a good source of probiotics.
5. Leafy Greens:
- Dark, leafy greens are rich in fiber and can promote bowel regularity. Examples include spinach, kale, and Swiss chard.
6. Olive Oil:
- Olive oil has a mild laxative effect and can be added to salads or used in cooking.
7. Flaxseeds:
- Flaxseeds are high in fiber and can be added to yogurt, smoothies, or sprinkled on top of cereal.
8. Kiwi:
- Kiwi is not only a good source of fiber but also contains an enzyme called actinidin that can aid digestion.
9. Whole Grains:
- Opt for whole grains instead of refined grains to increase your fiber intake. Choose whole wheat bread, brown rice, and whole grain pasta.
10. Fermented Foods:
- Fermented foods, such as sauerkraut, kimchi, and kefir, contain probiotics that can support gut health.
11. Dried Fruits:
- Dried fruits like figs and apricots are high in fiber and can be a convenient snack.
It's essential to gradually introduce these foods into your diet and ensure you are drinking an adequate amount of water throughout the day.
If constipation persists and you are not seeing benefit from OTC medications or diet changes, it's important to let your surgeon or PCP know.
After Spine Surgery was developed with the providers at Coastal Spine Institute, PC to help patients and caregivers prepare for the recovery process after spine surgery. The recommendations in this guide may not be applicable to your spine surgery. Consult with your medical team.