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Constipation is the number one most prevalent side effect of opioid medications, affecting 80% of people who are prescribed opioid drugs. It is for this reason that medical treatment is always offered for constipation upfront at the same time as the opioid prescription is initiated. It is also easier to treat potential constipation prophylactically (preventatively), as opposed to allowing it to develop into a serious problem which in turn can make it more difficult to resolve. Everyone offered an opioid medication will also be offered a daily stool softening regimen. An example would be taking Docusate twice daily and Senna once daily in order to maintain your normal bowels.  Your doctor will adjust the doses and choices of your stool softening medications depending on how they are working for you. The goal ultimately is to maintain your bowels at the same frequency that you were having them prior to starting the opioid. For example, if your normal is one bowel movement per day, the goal would be to maintain this even after starting the opioid, Your doctor will tailor your stool softening medications to help you achieve this goal. In addition to medications, there are also a number of lifestyle strategies you can use to keep your bowels moving as easily as possible while on the opioid medication. These include:  Eating plenty of fibre. Fibre helps to bulk up your stool and allows it to pass more easily. The recommended daily amount is 20–35 g/day. Drink plenty of fluids. Staying well-hydrated with at least eight to 10 8-oz glasses of water per day (and more with exercise) is key to helping your bowels stay soft and mobile. Get regular exercise. Staying physically active with at least five exercise sessions of 30 minutes or more per week helps not only with your overall health, but also with passing your stools and keeping your gut healthy. Try moving your bowels after a meal. There is a natural increase in colonic motility after meals, which may help. Colonic activity appears to be highest in the morning, so try going to the bathroom right after breakfast. Having a cup of coffee or other beverage with caffeine at breakfast may help with this. If the first line stool softening methods and lifestyle strategies are insufficient to keep your bowels moving at a healthy pace, your doctor may suggest other medical alternatives to help treat your constipation. These may include:  Milk of Magnesia The addition of an "osmotic laxative" such as Polyethylene glycol A medication called Methylnaltrexone for severe constipation Enemas and suppositories may be recommended as a last resort
Be aware of the risk of constipationf. Take daily stool softeners. Practice lifestyle strategies to keep your stool loose. Try other medical treatments if you continue to have problems.