# Extreme long term constipation/possible impaction



## BigUgly

Ok, this has taken me a long time to come here and post about. Well, really I had never knew this forum existed before a google search today, but I knew there were likely resources on the internet and I've avoided up until now. Here's the situation:I've been on very high doses of oxycontin for 3+ years now. For the majority of that time, I've had really bad constipation. Like, regularly go a month or more before I go. Now, obviously this is not normal, but even before all this started, I was never one who got the urge to go every day. Usually I would get the urge once every few days or more, and it always came out pretty easily. Once the opiates came my colon went to hell; my poops are literally the size of gatorade bottles (not the ones that are fat at the bottom but still) -- solid pieces that long and wide. The reason I am here now is because I'm afraid I may have impaction now. It has literally been 3 months now since I last pooped (early October). About 3 weeks ago, there was a week where I was in awful discomfort -- constantly having to get up and go squeeze, my stomach was killing me from the bloating and whatnot. Thankfully that has gone away and I still got slight stomach pains here and there, but at least it's not as bad as it was. For background, I HAVE had times in the last 3 years where it's been about 2-2.5 months before pooping. It's hard for me to tell when "the time" will come when I can go, but when I'm sitting there squeezing I just sometimes can "feel" that the time is right that it's trying hard enough to come out and I just push hard as I can and it comes out. I'm not sure why I think this time it may be impaction, but it just seems like it's just particularly hard this time and doesn't seem to be "moving" enough as usual when I push.I'm really worried about this, mainly because of fear of the unknown of what this may cause to happen to my body if I can't get this out. Please don't tell me horror stories of what could happen, but rather any recommendations you guys have for what to do to get this thing out. I've been praying constantly to help me get this out and I've told myself that if I can get this out, I am going to totally change my lifestyle, eating habits, and everything else to get this dealt with. It affects my quality of life COMPLETELY. I can't go do a lot of things because I never know when I'll have to squeeze and don't want to embarass myself shuffling to the bathroom.I haven't ever been to a doctor about this because it's obviously embarrassing as hell. From what I've read, with the impaction if an enema and everything else doesn't work, they end up having to use a finger to break it up. I'm not sure how this could work though since if it's as big as previous ones (again, gatorade size), he would damn near have to stick half his forearm up there to get all of it. Past that, I hear there is surgery but I'm praying that won't be the case.Also, would taking stool softeners help at this point? I've always thought that they help what comes AFTER or around the time you take the softeners and that it wouldn't help what is already in there. Is this true?Thanks for any help.


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## BQ

My gut feeling is GO to the Dr or ER... now. You should NEVER have left it go this long! As long as you are on oxycontin (which???? Don't know why someone would be on that this long???? So see if you can get OFF of that!) at the very least TAKE a stool softener! But being three months has gone on.... you are in trouble. You need to get this stuff out one way or another.Would taking a stool softener help you NOW??? No hon..In October maybe...but not now. You should be helped AT a hospital.


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## BigUgly

BQ said:


> My gut feeling is GO to the Dr or ER... now. You should NEVER have left it go this long! As long as you are on oxycontin (which???? Don't know why someone would be on that this long???? So see if you can get OFF of that!) at the very least TAKE a stool softener! But being three months has gone on.... you are in trouble. You need to get this stuff out one way or another.Would taking a stool softener help you NOW??? No hon..In October maybe...but not now. You should be helped AT a hospital.


I guess what I'm asking is what is the hospital going to do?


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## BQ

I don't know hon.. probably start with an enema at the least and go from there. You need to be seen though hon before you get into worse trouble. You need to get off of that oxycontin too... BUT do that with a Dr's help.... NOT on your own!Have some faith in yourself.. you now know you need at least a stool softener daily while on the oxycontin.... you may need more than that but ASK a Dr. ok?Let us know how you do.(((Hugs)))


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## BQ

Also, be proud of yourself for coming here and seeking help! You did the right thing hon!


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## em_t

First of all well done for coming here and posting, sometimes it's really difficult to talk about these things, but everyone here understands. I also suffer with terrible constipation, which is down to a lazy bowel as opposed to being opiate induced. First of all, stop reading what it says on the internet! Quite often the information is inaccurate or not relevant to your particular situation - so stop filling your mind with worst case scenarios. Secondly, you will probably have to go to the ER, but it won't be nearly as bad as you think. They will probably do an X ray to see how constipated / impacted you are. Depending on that they will probably offer you an enema, but it's usually not one of those ones that you imagine with the large enema bag, tube and huge amounts of water, they usually administer a Fleet enema, which is like a small water bottle with a nozzle attached containing a phosphate solution. On the 2-3 occasions I have had to do this, I've been allowed to administer it myself because it's easy to do and the nurses were understanding that it was an embarrasing situation. You lie on your side, keeping the liquid inside you until you get a cramping sensation like you need to go to the toilet, usually about 5-10 minutes. When you go to the toilet it is mostly enema fluid that you get rid of but if you do get rid of some stool it is likely to be quite liquid, so do be warned (sorry probably TMI, but best to be informed). On one occasion, the Fleet enema didn't work on me and all that I got rid of was enema fluid, but after an hour I was able to go, so sometimes it takes a bit of time to work. In my case, I've never had to stay in hospital as an inpatient and have been discharged with Miralax to take over the coming days in large quantities, you will need to be near a toilet and you may have to take some time off work. In your situation, they might prescribe you something slightly stronger like a colonoscopy prep, but even this shouldn't be too bad, you'll feel so much better once you finally get rid of some of that waste!Following that, you will have to take a maintanance regime of laxatives to prevent it from happening again. Doctors usually recommend Miralax, which you can increase or decrease as per your personal reaction. You can tailor it so you are having a minimum of 3 bowel movements a week, everyone's different so it'll be a little bit trial and error. If you have fewer bowel movements than that you may need to add in a stimulant laxative, but you should talk to a doctor about that as you don't want to become too reliant on them. I really recommend that you do see a gastroenterologist, they will have dealt with this before so don't be embarrassed, and hopefully it will prevent a situation like this again. I'm not from the US but I know in the UK if you are being prescribed opiates they also prescribe a gentle laxative with them as it's a very common side effect. Can I ask, have you been prescribed the opiates or are you taking them without a doctors knowledge? If they've been prescribed your doctor could perhaps change some of the medicines you are on or at least be able to reduce the amount of opiates you are taking. If you are self-prescribing, be honest with you doctor and they will be able to help you withdraw by gradually decreasing the amounts you are taking. Don't believe what they say on the internet about having to break it up or doing a manual evacuation. I think that is always a last resort when none of the laxatives prescribed have worked over the course of a couple of weeks. It is very likely once you start taking the disimpaction treatment that you will start to get rid of the waste yourself. You may have to go for subsequent X rays afterwards to assess the impaction, but your doctor should be happy enough once you start going again for you to continue on a laxative regime. As for surgery, that's usually only reserved for people who have not responded to any treatment over a long period of time. In the meantime there are plenty of things you can try - you can try taking a daily amount of Miralax, which is a gentle laxative which should encourage you to go to the bathroom more often. If this doesn't work you can also take a stimulant laxative say once a week to get the bowel working. Sometimes, you may be prescribed a daily enema to take. My gastroenterologist has prescribed this but they are tiny, they only hold a small volume, 5 mL and they encourage your body to get into more of a regime. My main message, is that there are ways to manage this but you need to seek a doctor's advice - you can't manage this on your own. You must feel terrible for not going to the bathroom for so long. I know I feel uncomfortable after 4-5 days and if it's been anymore than a week, I seek treatment. So please seek treatment, and take advice about other painkillers or combination of painkillers that you can take as the opiates aren't doing you any good.I hope this has been useful and hopefully not too off-putting. What I really want to get across is there are ways of coping with this, but you need an experienced doctor to help you - and I know it's embarrassing but they really have all heard it before!


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## lindielou

I agree with Prolific Member. Excellent advice, get to a gastroenterologist as soon as possible.


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## BigUgly

Thanks for all the advice. I have actually given myself an Fleet Enema before; back when the constipation first started I had never not pooped so long and got scared reading BS like "if you don't poop for a few weeks you will start to get backed up and eventually you will start vomiting poop." So I gave myself one and it worked, and I think I gave myself one another two times as well. I've thought of doing it with this situation, I guess if that's all the doctor is likely to do I could just attempt it by myself before going, especially since I no longer have health insurance. I suppose I'll try to do the enema and if that fails then I guess I'll have to break down and go to the doctor. As far as the opiates go, I did originally have a prescription, but after they took me off of them and the doctor did an almost nonexistent job of tapering me off, I started getting w/d's and went to get them other places and thats where I still am today. I know almost for sure the opiates are the main factor causing it; my diet (meats, almost no vegetables/fruits) I know also plays a factor. For a while there I was literally eating nothing but Raisin Bran and it seemed to help a lot since the poop was more pliable so to speak and could get out easier. Right now the stool is so hard it literally feels like a ROCK inside me. I don't want to even imagine how much is backed up in there after 3 months; I've cut back eating a lot so it's not like it's 3 full meals a day in there, but still.Appreciate any prayers you guys can send my way. I'm really worried about it this time, I've never really got worried before even though I've gone 2.5 months a couple times before, but this time it just seems a little worse.


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## BQ

Yah it IS kinda bad hon. So please.. insurance or not... get to the Dr or ER if the Fleets doesn't work. And then go to a Dr for help in getting OFF the oxy.


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## BQ

Thinking of you! And sending good stuff/thoughts your way..... Let us know how you are doing when you can.


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## mcwifey

When I've experienced long term constipation 10-14 days, the Fleets didn't work on me either. They used a Crisco (milk & oil) enema. It was effective in 30 seconds.Good luck & keep us posted!!!


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## annie7

oh yes, the mineral oil enemas do work well. i had a major impaction when taking the sitz marker test and a fleets mineral oil enema really took care of that well.good luck. hope you've been able to get to the doc and/or the ER by now and hope you're doing better. sending prayers and positive thoughts your way.


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## IBS_Bane

In an arguably better time- most homes had a proper enema bag occupying a place of honor in the bathroom. Using it properly was also rather unremarkable. some of us may need it more or less often. If it works- use it. Let's be practical- after a while an enema can even becoming comforting on so many levels.

Being free from pain and worries is worth a bit of hopefully not unpleasant "healing ritual" time.


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