Re: Dilaudid and gas pain?

[Guest guest]

Faye A wrote:

> My Rheumy recently put me on Dilaudid for breakthrough. I have been on it for

3 weeks now and have developed severe gas pains and even have vomited...has this

happened to anyone else? It really helps the pain but the GAS is a bad problem.

All opioids (Dilaudid, Oxycontin, Vicodin, etc) are powerful

constipating agents. And sadly, this is one side effect that won't go

away with time.

I recently read of a name for the whole set of digestive symptoms that

afflict many chronic pain patients: Opioid Bowel Dysfunction (OBD). The

problem is that opioid receptors aren't found in just the brain and the

spinal cord, where they provide pain relief when activated. They're also

all through the gut. And when you trigger them, normal peristalsis slows

way down and constipation results.

I've read of clinical trials of certain opioid antagonists to block the

constipating effects of opioid pain medications. The problem is to find

an opioid blocker and a dosage that won't also cancel the pain relief

that you want and maybe even trigger withdrawal.

Some studies showed good results with oral methylnaltrexone, an opioid

blocker that doesn't easily cross the blood-brain barrier, but it

apparently isn't available in the US. There already are opioid agonists,

like Immodium, that don't cross the blood-brain barrier, which makes

them useful in treating diarrhea.

Does anyone else on the list have any actual experience with the use of

opioid blockers to treat opioid bowel dysfunction?

Phil