Opioid-Induced Constipation: Causes, Relief, and What Works

When you take opioids for pain, your body doesn’t just stop feeling pain—it also slows down your gut. This is opioid-induced constipation, a side effect caused by opioids binding to receptors in the digestive tract, reducing muscle movement and fluid secretion. Also known as opioid-related constipation, it’s not just discomfort—it’s a real medical issue that affects up to 90% of long-term users. Unlike regular constipation, this one doesn’t get better with just more fiber or water. It’s built into how opioids work, and it sticks around as long as you’re on them.

That’s why laxatives, medications designed to help move stool through the intestines are often the first line of defense. But not all laxatives work the same. Bulk-forming ones like psyllium? Usually not enough. Stimulant laxatives like senna? They help, but can cause cramping. Then there are newer options like methylnaltrexone and naloxegol—drugs that block opioids in the gut without touching pain relief in the brain. These are game-changers for people who need pain control but can’t live with constant bloating or pain from backed-up stool.

And it’s not just about pills. bowel function, how well your digestive system moves and empties gets disrupted by opioids in ways you might not expect. Reduced gut motility means food sits longer, gas builds up, and you feel full even when you haven’t eaten much. Many people stop moving as much because they’re in pain or tired—and that makes it worse. Light walking, even just 10 minutes after meals, can help keep things moving. Hydration matters too, but again, drinking more water alone won’t fix it if the gut itself is frozen by the drug.

What’s missing from most doctor visits? A plan. Too often, patients are told to "just take a laxative" and left to figure out the rest. But opioid-induced constipation needs a strategy: which laxative to start with, when to step up, how to track progress, and when to ask for something stronger. It’s not a sign you’re doing something wrong—it’s a side effect you’re entitled to manage.

The posts below cover real-world solutions from people who’ve been there. You’ll find guides on which medications actually work, how to talk to your doctor about alternatives, and even how gut health interacts with long-term opioid use. Some posts dive into how opioid itching and constipation are linked through the same nerve pathways. Others show how newer pain treatments are designed to avoid this problem altogether. This isn’t theoretical advice—it’s what people are using right now to get their lives back.