Talk Cancer

Question:

I’m sure this questions gets asked a lot so I hope people will take time to answer. I am taking narcotics for pain of pancreatic cancer. As anyone who takes these knows, narcotics can slow your bowel way down and are known to cause terrible constipation and even blockage.  Personally, I have a cholostomy which makes it more noticable and more uncomfortable for me. I am looking for suggestions from those of you with experience on how to fight the constipation: On stool softeners, any idea what is the right amount to take for a given amount of narcotic? I currently take about 80mg oxycontin per day and even when I take double the recommended dosage of colase, I am bound up like a rock. On fiber supplements: the cancer nurses (who i think know pretty well) recommend NOT USING THESE when on narcotics.  The supplements become bound like cement.  Thoughts on this? How about diet?  If I eat high-fiber, am I going to be in same trouble as if I take supplements. Anyone found anything to eat that is particularly good? Prunes? Juices? I look forward to any advice you all can offer. Thanks in advance! Pete Boulder, CO

Response:

I’m sure this questions gets asked a lot so I hope people will take time to answer. I am taking narcotics for pain of pancreatic cancer. As anyone who takes these knows, narcotics can slow your bowel way down and are known to cause terrible constipation and even blockage.  Personally, I have a cholostomy which makes it more noticable and more uncomfortable for me. I am looking for suggestions from those of you with experience on how to fight the constipation:

I also had pancreatic cancer, but the cancer was found to be a rare pancreatic lymphoma rather than the more common adenocarcinoma. At any rate, I now have chronic pancreatitis for which I take narcotics from time to time. My surgeon recommended that I use Senekot, a natural over-the-counter laxitive. He suggested that I initially try one or two pills with each pain pill dose, but that I experiment to find what works for me since everyone’s system is different. If I take two Roxicodone, I take two Senekot – but I don’t take more than 6 Senekot/day. This works for me and is within the recommended dosage on the Senekot bottle. I have found that most drug stores carry generic versions of Senekot which work just as well and cost much less. DonS The Pancreatic Duct – http://www.sterner.org/~dsterner/pancreas

Response:

- Hide quoted text — Show quoted text -I am taking narcotics for pain of pancreatic cancer. As anyone who takes these knows, narcotics can slow your bowel way down and are known to cause terrible constipation and even blockage.  Personally, I have a cholostomy which makes it more noticable and more uncomfortable for me. I am looking for suggestions from those of you with experience on how to fight the constipation: On stool softeners, any idea what is the right amount to take for a given amount of narcotic? I currently take about 80mg oxycontin per day and even when I take double the recommended dosage of colase, I am bound up like a rock. On fiber supplements: the cancer nurses (who i think know pretty well) recommend NOT USING THESE when on narcotics.  The supplements become bound like cement.  Thoughts on this? How about diet?  If I eat high-fiber, am I going to be in same trouble as if I take supplements. Anyone found anything to eat that is particularly good? Prunes? Juices? I look forward to any advice you all can offer. Thanks in advance! Pete Boulder, CO Hi Steve,

As has been mentioned, senokot is  a very good laxative stimulant and it also has a form which contains a stool softener called senokot-S. We recommend that this be used for all pts who are on narcotics and have used doses of 2 t 4 tabs 4 times a day. The amt needed is individualized to the pt, the dose  of the narcotic and diet. Yes, all of the "natural" diet interventions like prunes are also a good idea. The reason that taking bulk laxatives is not a good idea is because they tend to cause the bowel to absorb water and without a good stimulant in the presence of narcotics, the stuff just "sits there" and turns into cement. Another medication that has to be prescribed, but tends to work well (even causing diarrhea) is cephulac (lactulose). Pat RN Oncology – Hide quoted text — Show quoted text –

Response:

Hi Pete,           I had a pull up op for cancer of the esophageas nearly 5 years ago, i lost a good part of my stomach at the same time,  I take MST 40 mg twice a day , this does give me some problems with constipation, the best thing I can find is fresh orange juice which seems to help with the constpation and I feel can’t be doing me any harm, i am a bit frightened of laxatives as is does not take too much for me to have a problem and go the other way. Yours  John J.F. Smith Delaware Pilgrim’s Way Harrietsham Kent ME17 1BT Tel: 01622 858142

Response:

Pete, What works for my patients is Golytely – the gallon of laxative that I use for colonoscopy preps. For narcotic constipation, I ask my patients to take 1 tsp of the powder in 8 oz of water twice a day and to use moderate fiber in the form of Citrucel. It is important to drink at least 6 glasses of fluid daily. Ask your doctor about that and check out our office website for more info at www.gihealth.com. Dr. Fusco

Response:

1/4/98    I have been terribly constipated for a number of years. Have tried all of the fibers and stool softeners (including Colace) without attaining any real relief. Dr. suggested trying Mineral Oil (Ugh!!!). After trying 1 tablespoon each night I found out two things: You eventually get used to the (Ugh) taste, second it allows you to attain a movement every two to four days!!!!      The oil does ease the movement even though you may have to strain to get it started. Try it! I won’t promise you’ll like it , but I hope it will help you like

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