# Should I stop taking Codeine?



## Jimbob94

Hello everyone,I'm a 17 year old male whose IBS began in November 2010 after an episode of food poisoning. My main problem to begin with was diarrhoea, which was worsening in terms of frequency (sometimes 10+ in a day). I had tried medications such as buscopan, colofac, peppermint capsules (colpermin), and immodium without any improvements in my symptoms. In about May/June 2011, my doctor prescibed me codeine phosphate 30mg and told me i could take up to 4 a day, which i did every day. For a few months it gave me some relief from the D and pain which i needed so i could start attending college again after having to leave. A few months ago i lessened the dosage to 1 or 2 a day, which is what i take now (plus amitriptyline 10mg). I still usually have 5+ BMs a day on this dosage, plus a lot of gas and bloating, even on the low fodmap diet. I am thinking of asking my doctor how to come of the codeine completely because i don't want my body to be reliant on them. When i do miss a day or so of taking the tablets i have quite a weird pain/ache in my stomach. Any advice would be thoroughly appreciated! Thank you


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## BQ

> I am thinking of asking my doctor how to come of the codeine completely because i don't want my body to be reliant on them.


That would be a very good thing to do.. so definitely discuss it with your Dr. And let him know about the feeling you get when you skip a day or two.. Have you thought about using calcium carbonate supplements to help firm up your D? Please see the 1st page of the "Linda's Calcium" thread thumbtacked to the top of the Diarrhea Forum for more info on which supplements, how much of them and when to take them.


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## Jimbob94

Thank you, i shall book a doctor's appointment for next week. Do you think there may be any lasting effect from taking the codeine for so long? I feel that i wasn't very well guided with using it from the start.Yes thanks for mentioning the thread, i came across it a few weeks ago. I then bought some tablets from a health food store which are 333.3 mg of calium/ 133.3 mg of Magnesium/ 8.3 mg Zinc - although now i'm not sure if these would be appropriate though as magnesium isn't the best for D so i understand.


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## Kathleen M.

Yep, for the constipating side effect of calcium tablets you want the ones that don't use magnesium to balance out the constipating side effect. There are some other reasons to combine them, but that is a pretty big reason why they combine them.


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## Jimbob94

That makes sense and i'll have another look on the calcium thread, thank you Kathleen.


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## faze action

Jimbob94 said:


> Do you think there may be any lasting effect from taking the codeine for so long?


If you ask your doctor this I'd be interested in knowing what (s)he says. I took prescription codeine from the time I was about 6 years old until I was in my 20s (for chronic migraine). About two years ago (I'm 40 now) I took codeine after a dental procedure and it made me so nauseous it was unbelievable.


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## BQ

Most serious pain relievers (narcotics) give me nausea. They didn't use to... but they do now. I don't know why that is though.


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## Jimbob94

My doctor didn't mention the long term effects i'm afraid, it wasn't as helpful as i was hoping. I was just told to lower the dose, which i'm not sure if i can because i only take 1x 30mg tablet a day now. Then for the stomach pain i reported when i don't take codeine, the doctor told me to take paracetamol. I'm guessing another trip to a different doctor this week will have to be made because i didn't find out how long it would take to get off them. I'm worrying about the effect of codeine on my stomach now, because i've been fairly constipated the last few days, and yesterday i had a day of pain in my lower abdomen, particularly the left side, which i haven't experienced before. The pain hasn't eased up that much today so i'm not sure whether to take a laxative or what else to do really- sorry to go off subject a bit here.


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## faze action

Jimbob94 said:


> My doctor didn't mention the long term effects i'm afraid, it wasn't as helpful as i was hoping. I was just told to lower the dose, which i'm not sure if i can because i only take 1x 30mg tablet a day now. Then for the stomach pain i reported when i don't take codeine, the doctor told me to take paracetamol. I'm guessing another trip to a different doctor this week will have to be made because i didn't find out how long it would take to get off them. I'm worrying about the effect of codeine on my stomach now, because i've been fairly constipated the last few days, and yesterday i had a day of pain in my lower abdomen, particularly the left side, which i haven't experienced before. The pain hasn't eased up that much today so i'm not sure whether to take a laxative or what else to do really- sorry to go off subject a bit here.


I've read (in the article below and other sources) that there are instances of hyperalgesia that can occur with longterm opioid use. Basically, you become much more sensitive to pain due to long term effects of the drug:http://www.painphysicianjournal.com/2008/april/2008;11;S105-S120.pdfMaybe that's partly what you're experiencing?


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## IBS-D guy

I stopped codeine Approx 9 days ago after approx 3 years of use. I suffered increased pain and discomfort initially though it did pass as the week went by. I'm using Nortriptyline to replace the codeine and am hoping it will help manage my condition. As others have said speak to your dr about your concerns. I know that codeine tablets are small but you could always cut tablets in half if you wanted to reduce your dose further


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## Jimbob94

faze action said:


> I've read (in the article below and other sources) that there are instances of hyperalgesia that can occur with longterm opioid use. Basically, you become much more sensitive to pain due to long term effects of the drug:http://www.painphysicianjournal.com/2008/april/2008;11;S105-S120.pdfMaybe that's partly what you're experiencing?


Thank you for the article faze action. I think you may be right there. I'm hoping it's not the case, but if it is, that it's not a lasting problem. I should be scheduled an appointment with my gastro doctor in the next couple of months so i'll definitely bring that up with him.


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## Jimbob94

IBS-D guy said:


> I stopped codeine Approx 9 days ago after approx 3 years of use. I suffered increased pain and discomfort initially though it did pass as the week went by. I'm using Nortriptyline to replace the codeine and am hoping it will help manage my condition. As others have said speak to your dr about your concerns. I know that codeine tablets are small but you could always cut tablets in half if you wanted to reduce your dose further


Thank you for sharing your experience with the codeine. I hope the nortiptyline works well for you.Did you come off the codeine gradually? Also that is a good idea of halving the tablets, i think that's what i'll be trying now.


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## IBS-D guy

Jimbob94 said:


> Thank you for sharing your experience with the codeine. I hope the nortiptyline works well for you.Did you come off the codeine gradually? Also that is a good idea of halving the tablets, i think that's what i'll be trying now.


I was using 30mg per day 6 days per week. I would always try to have 1 day a week off the codeine (normally a sunday when i dont go to far from the house) to help reduce the likelihood of withdrawal issues or side effects. I didnt come off gradually. i took one tablet of the saturday morning as normal because i had an important appointment to attend and started nortriptyline of the evening. I havent had any codeine since. I took a week off work in case i had problems with the meds and didnt venture very far from the house during that week. Ive gone into work twice this week with no codeine in my system which is the first time ive been able to do that in approx 4 years so the nortiptyline is providing some relief.


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## Jimbob94

IBS-D guy said:


> I was using 30mg per day 6 days per week. I would always try to have 1 day a week off the codeine (normally a sunday when i dont go to far from the house) to help reduce the likelihood of withdrawal issues or side effects. I didnt come off gradually. i took one tablet of the saturday morning as normal because i had an important appointment to attend and started nortriptyline of the evening. I havent had any codeine since. I took a week off work in case i had problems with the meds and didnt venture very far from the house during that week. Ive gone into work twice this week with no codeine in my system which is the first time ive been able to do that in approx 4 years so the nortiptyline is providing some relief.


That's good to hear that you're managing well without it, i hope you continue to do well. Thank you for that, i may try to stop taking it over the Easter holiday and see how i do. Thanks again


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## Dr Dani MD

Hi Jimbo,You are very smart to want to come off the codeine. It can actually become addictive and can also make ur IBS worse, because it affects the gut (or digestive system muscle) motility (or ability to move food/material thru the digestive system). As for the pains when u skip a day, that is likely ur gut 'readjusting' to not having the codeine on board--things should improve after you are off the codeine completely for a month or so. If the pains get worse even after that, talk to your doc to rule out other things besides IBS and if all is clear, it could be an IBS symptom u can treat by many non-drug meansHope this helps you!Dr. Dani


Jimbob94 said:


> Hello everyone,I'm a 17 year old male whose IBS began in November 2010 after an episode of food poisoning. My main problem to begin with was diarrhoea, which was worsening in terms of frequency (sometimes 10+ in a day). I had tried medications such as buscopan, colofac, peppermint capsules (colpermin), and immodium without any improvements in my symptoms. In about May/June 2011, my doctor prescibed me codeine phosphate 30mg and told me i could take up to 4 a day, which i did every day. For a few months it gave me some relief from the D and pain which i needed so i could start attending college again after having to leave. A few months ago i lessened the dosage to 1 or 2 a day, which is what i take now (plus amitriptyline 10mg). I still usually have 5+ BMs a day on this dosage, plus a lot of gas and bloating, even on the low fodmap diet. I am thinking of asking my doctor how to come of the codeine completely because i don't want my body to be reliant on them. When i do miss a day or so of taking the tablets i have quite a weird pain/ache in my stomach. Any advice would be thoroughly appreciated! Thank you


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## Jimbob94

Dr Dani MD said:


> Hi Jimbo,You are very smart to want to come off the codeine. It can actually become addictive and can also make ur IBS worse, because it affects the gut (or digestive system muscle) motility (or ability to move food/material thru the digestive system). As for the pains when u skip a day, that is likely ur gut 'readjusting' to not having the codeine on board--things should improve after you are off the codeine completely for a month or so. If the pains get worse even after that, talk to your doc to rule out other things besides IBS and if all is clear, it could be an IBS symptom u can treat by many non-drug meansHope this helps you!Dr. Dani


Hello Dr. Dani,Thank you for your post, that information has helped me. Looking back i do wish i was given more guidance by my GP (who prescribed the codeine), as all i knew at the time was that it would help the terrible d and pain i had every day; unfortunately i wasn't aware of the possible long term affects until months after. Immodium didn't help me so the codeine seemed like the only other option at the time.I do find that the codeine makes me constipated, which isn't good because it causes more gas for me. Therefore before i go out i'll have about 6 peppermint teas to get things moving however that also is quite a nuisance due to the pre-ibs bladder problems i have had to put up with the last two years. Hopefully i will be off it soon, although i am slightly apprehensive to stop taking it completely at the moment, as i haven't finished my year at college yet and my attendance is already very low.Thank you again for your help!


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## jmc09

Ive been taking 60mg 3 times a day of codeine for about 18 months and it hasnt effected me at all. It does nothing for pain but does help a lot with ibs d.I also took codeine for about 18 mths about 20 years ago and can stop it overnight if there was a better option for stopping diarrhoea.At your dose i wouldnt worry at all if i were you.


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## Jimbob94

jmc09 said:


> Ive been taking 60mg 3 times a day of codeine for about 18 months and it hasnt effected me at all. It does nothing for pain but does help a lot with ibs d.I also took codeine for about 18 mths about 20 years ago and can stop it overnight if there was a better option for stopping diarrhoea.At your dose i wouldnt worry at all if i were you.


Thank you for sharing your experience. I have actually found it fairly easy coming off the codeine, i only felt rough on the third or so day without it. My D has worsened as i expected and i have been in pain when i wake up in the morning however this is pretty much how i felt back when i didn't take it so i'm not particularly worried. At the same time i have also stopped taking amitriptyline (10mg) as i felt it wasn't making a difference, but i might start it again now i'm not taking codeine, so i can notice its effects more. To try and manage my D now i'm going to buy some calcium caltrate 600mg, and some immodium plus (if needed) until my next gastro appointment.


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## jmc09

Good luck but dont be scared of taking a codeine or two if necessary,its not addictive for everybody.


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## Lempster

Hi Jimbob-I'm a newbie here, but have been troubled with IBS for many, many years. My doctors tried many meds with me also - Creon, Bentyl, Lomotil, Entocort, Colestid, Cholysterimine powder, Paregoric, immodium, pepto bismal, and now codeine. I take 2 30mg tablets 4x a day and it has been wonderful. I do have the occasional flare up, but I take 4 immodium and it helps a lot. I've been on the codeine for 4 years now and was very hesitant in taking it because of addiction. I even asked my doc about potential abuse of it and she said it was very low. I also take Amitriptyline (for arthritis) and besides it making me horribly groggy it does cause me some diarrhea in the morning and gas during the night. For the diarrhea in the morning I take 500mg of Tumeric. Tumeric is used in cooking mainly in India. People from India do not have bowel problems and this is because of so much Tumeric in their food. NIH also found that most people have hook worm, which slows the GI tract. Do you happen to have Anklyosing Spondlitis (sp?)? This form of arthritis causes diarrhea and false negatives when having blood work to test for Celiac disease or other IBDs. Talk with your doc and see about taking Gabapentin instead of the Amitriptyline. Works much the same and has fewer side effects. Hope some of that helps you.


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## Above0924

The only thing that has provided me relief is pain meds. As soon as I came off of them, all of my symptoms were back. While I was on them I felt like normal, like I did before any of this crap, no pun intended, began. I am surprised you have no withdrawal after taking codeine for so long. Although, that is way more milder than what I was on. Coming off codeine will be a blessing and a curse. Although, if you do not experience withdrawal when not taking it, why not continue if it gives you relief?


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