Digestion Issues and Narcotic Bowel Syndrome

Discussion in 'Fibromyalgia Main Forum' started by SkeptikSharon, Sep 11, 2008.

  1. SkeptikSharon

    SkeptikSharon New Member

    Hey all,

    I had started seeing a GI doc not too long ago for the digestion issues I am having, primarily constant nausea, abdominal pain, and constipation. I had an endoscopy done, which was essentially normal, and need to go back for follow-up with him. One of the things he had brought up when I saw him the first time was the possibility of something called Narcotic Bowel Syndrome, due to the fact that I am on a narcotic and have been on various meds for several years. The nausea has been going on for a long time (almost constant since 2006), but the pain and constipation are a bit more recent (last year or so).

    At this point, I have lost way more weight than is healthy for me due to the trouble I have with eating. I am 5' 6.5" and today the scale shows 90 pounds. In December I was at 130 pounds and by May I was down to 115 pounds. Only now have the docs become concerned.

    I have been on one narcotic or another for the last couple years and am currently taking 2mg of Methadone Liquid, weaning down very slowly from 5mg. I tend to get really bad withdrawal symptoms, so that's why its going so slowly.

    The GI doc thinks that this Narcotic Bowel Syndrome may be causing the digestive problems, and I truly hope that is the case, since I am weaning completely off all narcotics. I am afraid of not having anything to treat the pain, but the narcotics weren't doing their job anyway.

    Have any of you heard of this syndrome? I had tried to do some research on this, but had difficulty coming up with any info, especially as to how to treat, other than going off narcotics completely and staying away from them. Most links take me back to the same study, which seemed to focus more on those with IBS who were taking narcotics for that condition. Have any of you developed digestive issues after being on narcotics?

    The nausea and the pain are particularly disturbing, definitely keeping me from getting anywhere near enough calories in a day. I have cut out junkfood and other bad stuff for the most part, but it continues to feel bad. I am waiting to see if going off the meds will help. Its weird, because every time I eat anything, I can't eat much and all I feel is pain. I don't feel hunger. I feel pain. And when my tummy gets gurgly, I can actually feel with my hand what feels like hard bubbles in my stomach that really hurt and don't go away unless I massage my stomach. But they come back. I've never had these kind of issues before (maybe some of the nausea, but not the rest). At times, I can also feel my heartbeat REALLY strongly in my stomach, and that sensation is very disturbing. Maybe its normal. I don't know. I just don't know anymore what is normal.

    I did do a search on here for digestion issues, but couldn't really find anything that really fit this topic.
  2. Catseye

    Catseye Member

    When you google for digestion problems, include "natural remedies" in the search title. Then you will exclude all the medical advice. The medical profession cannot adequately treat digestive issues because you need a specific diet and supplements and they don't deal with those. Doctors pretty much follow the food pyramid and CFS and fibro-ers need special attention. Things like avoiding the obvious junk foods, but also wheat and dairy and most grains.

    Narcotics, especially those with NSAIDs, disrupt digestion because they inhibit the prostaglandins that are responsible for the stomach lining that protects you from its acid and they also do damage to the intestinal lining.

    Once you've gone "over the edge", and have developed CFS, you'd be really lucky to come around on your own by just doing general recommendations and quitting all the NSAIDs and unhealthy food. Like you could eat healthy and take probiotics and all, but the damage has been done and you probably need to help the body along with some supplements. Zinc and betaine hcl could be crucial, they were for me.

    Look at these posts that I did today - click on my name and my profile will come up and you'll see them - then you can click on them and read them:

    manuel, about digestion



    They're pretty long but they have some of the info I think you'd care to read.

    best wishes

  3. luvdogs

    luvdogs New Member

    Do go off the narcotics, just because it's better for you in general. My method for weaning off meds is to decrease the medicine very very slowly. However, if you weigh 90 lbs., you need to be worried about more than narcotics, unless you're taking large amounts of it. You need a good thorough evaluation, probably by a panel of docs. You are in danger of becoming very ill if you lose more weight than that.

    For stomach issues, I would immediately go on a good probiotic, one that needs to be refrigerated. Try to eat lots of fruits and veggies, but also try some high calorie foods, because you need to gain weight immediately. Have you been checked for celiac disease--that causes tons of GI problems. For God's sake, get some blood tests, and soon.
  4. Rafiki

    Rafiki New Member

    Something must be done about the state of your health asap. You will be consuming your own muscle now and your heart is a muscle.

  5. ellikers

    ellikers New Member

    I agree with barrowinnovations that it sounds like the narcotics have affected your stomach and intestinal lining (which is part of what causes IBS in most people, at least in my case).

    I have more experience than I would like with digestive woes! I had IBS for years and the only thing that I found that helped was very gentle herbs. If you would like to give that a try to see if your belly would feel better, you can go visit a local nutritionist store and look up digestion.

    Here are the ones that I've found are very helpful (and I was prescribed my a naturopathic doctor):
    - marshmallow root (not marshmellows! don't worry!)
    - slippery elm
    - deglycyrrhizinated licorice

    They help heal the lining of your GI tract and create good things in your belly to help break down food (ease the gurgling you have and the pressure).

    You can find the blend I take by searching for "GI encap" on google. That will give you the amounts in each pill. I take 2 with meals.

    I really hope something helps to stabilize your belly while you try to gain weight and get off the narcotics.
  6. SkeptikSharon

    SkeptikSharon New Member

    Luvdogs – Thank you for your concern. I am going off the narcotics, very slowly. I don’t think my dose of methadone was very high to begin with, only 5mg, but when I had cut it in half, I ended up in the ER with really bad withdrawal symptoms. So at this point, I have been going down by 0.5mg a week, and am now down to 2mg. Only 4 more weeks to go! Yay!

    But you are right. I do have more to worry about than just that. I can’t lose more weight than I already have, because I know it can lead to organ failure and other issues. I’ve been trying to find different docs to help me with this, and have a ton of appts scheduled for the next couple months. Fun, fun. No, I’ve never been tested for celiac disease. I was hoping that the GI doc would do some comprehensive testing, but it seems like he is pretty certain it’s the narcotics. Should I try a different GI doc or a different kind of doc?

    Rafiki – Good point about the heart being a muscle. I am very concerned about that, especially since at this point, every time I stand, I feel palpitations and am pretty sure my blood pressure drops severely, because I get extremely dizzy. I was at the DMV yesterday morning, and as I was standing at the window waiting, I could just feel my heart pounding, pounding, pounding. Scary! I never had heart problems that I knew of before!

    Ellikers – Thank you for your suggestions too. I will look into those as well. Its so sad that the people that are most concerned about my severe weight loss are NOT my docs! This is ridiculous. I will definitely look into the suggestions everyone has made and see if I can get this under control. Because otherwise, something’s going to give, and I would prefer that it NOT be my body.
  7. luvdogs

    luvdogs New Member

    Keep going off the narcotics, but try another doc, or additional docs. You need to find someone who's more seriously concerned about your overall health.
  8. SkeptikSharon

    SkeptikSharon New Member

    I received a copy of my endoscopy results in the mail today. It showed erythema in the third portion of the duodenum, gastritis (mild hemorrhagic?) and a mildly patulous pylorus. Esophagus was normal.

    They took biopsies, and in the small intestine, it was all normal. In the distal espohagus, it showed "mild hyperplasia and reactive cytologic atypia with no evidence of viral cytopathic change and/or malignant neoplasm" of the "esphogeal squamous mucosa." It also says, "gastric cardia glandular mucosa exhibits foccal mild to moderate chronic inflammation with mild reactive/regenerative glandular atypia." The culture results show negative for h. pylori, but it looks like that is all they checked for.

    Anyone know what any of that means? It sounds like there is something going on, but seems mild enough that the doc's probably not going to do anything.

    The report was kind of cool though, because it showed pictures of my insides on one of the last pages. Too cool! =)
  9. ellikers

    ellikers New Member

    Let's see if I can help ...

    "esphogeal squamous mucosa" is just the name lining of the esophagus, the type of tissue that is what we see through a scope for example (the tissue type is called squamous epithelium and the mucosa comes from the fact that it's a tissue type that secretes mucous to help us digest, so that layer is called the mucosa)

    "mild hyperplasia and reactive cytologic atypia with no evidence of viral cytopathic change and/or malignant neoplasm" I think means that the cells are dividing a lot (somewhat more than normal) but it doesn't look dangerous (ie cancer level)

    "gastric cardia glandular mucosa exhibits foccal mild to moderate chronic inflammation with mild reactive/regenerative glandular atypia." What a MOUTHFUL! Gastric cardia is the either the stomach or where the stomach meets with the esophagus (I think gastric cardia means the area of the stomach near the heart, which is the junction between esophagus and stomach ... glandular mucosa with focal inflammation sounds like a fancy way of saying that the area we just talked about has irritated tissue and is developing cells that are somewhat abnormal (probably because they are irritated)

    Whoosh! So that was my best understanding of those terms. My take on tall that: It sounds like your stomach (esp. your junction from esophagus to stomach) is stressed and irritated and the cells that look abnormal (that they mention) are trying to repair what is damaged and having trouble, but it doesn't sound like it's that worrisome or cancer-provoking, so be reassured. :)

    Shouldn't medial people translate this stuff for us?? I love when my NP does that and helps me understand.

  10. PVLady

    PVLady New Member

    Yes I believe I did have that problem. I was on MS Contin for 9 months several years ago. During that time I became progressively sicker with all the same problems you are describing, including the weight loss because I could not eat.

    I would like to strongly suggest you get checked for gallstones. In Nov 2006 after many tests, finally my doctor ordered a simple ultrasound to check for gallstones.

    I was loaded with them. Everything fell into place, I had been really sick with gallbladder disease.

    When I took the MS Contin it was as if my colon was completely frozen. It was horrible and I know I was so toxic.

    When I went off the MS Contin, I was fortunate to see a doctor who knew about Subutex. With Subutex you can stop all opiates with no tapering, and no withdrawals.

    You must see a doctor who is licensed to prescribe Subutex because they need to know the protocol. They must have special training to prescribe it.

    Subutex is also a mild opiate and treats pain, however it is not at all like normal opiates. It only affects certain receptors in your brain, not the same as other opiates.

    You have absolutely no high feeling from Subutex - and it is dissolved under your tongue.

    Anyway, I hope you can be checked to rule out gallstones, and if you want to stop the opiates, check out Subutex.

    I see you are in Los Angeles. (so am I) You can consult with Dr Rick Chavez in Redondo Beach, CA. He is the very best pain treatment doctor and has been my doctor for over 5 years. He is the one I saw to get off the MS Contin.

    I will tell you, when he starts you on Subutex you stay in his office a few hours, then he stays in close touch with you for several days. You can call him on his cell phone directly.

    He is very good to give you all the medications you need when necessary. He only treats pain. He is the medical director of the Little Company of Mary Pain Institute in Torrance, CA.
    [This Message was Edited on 09/15/2008]
  11. Has your dr. done a stomach emptying test? (Not sure of the medical name for it) Your problems sound like mine and I have gastroparesis, let me tell you, it is so painful. I am awake in the middle of the night massaging my severely painful stomach . Do you bloat really bad also? Do a search and see if it sounds like that.
  12. PVLady

    PVLady New Member

  13. ellikers

    ellikers New Member

  14. SkeptikSharon

    SkeptikSharon New Member

    HI All,

    Thanks for your responses. I will take your suggestions into consideration and will definitely ask to be evaluated for my gallbladder and the gastroparesis thing.

    Unfortunately, I do not believe I will be posting on this forum very much, because of the attitudes of some of those anti-Lyme posters. It adds way more stress on to me to see how people are treated, such as in the "Who has FM or CFS only" thread. I just don't think its fair to accuse people of hijacking posts or to be rude to them because they have a diagnosis of Lyme (or even are just talking about it). I have never seen such intolerant people before. Oh wait! I actually have, but that was in a cult, not in a medical support group.

    I really just don't understand why we can't all sympathize or better yet, empathize with each other, regardless of whether Lyme is added as a diagnosis. Maybe I just have an overdeveloped sense of justice and fairness and KINDNESS, but it is just so wrong to me. When someone is approached the way these anti-Lyme posters approach others, all that is going to do is scare them off the board, and then they have to look for support elsewhere, if they aren't scared of the support groups altogether.

    At least this thread was started by ME, so I can't be accused of hijacking my own thread. =)

    I did want to say thank you to those of you who are open-minded and realize that there are many conditions that can happen in conjunction with FM and CFS, who realize that we all need support regardless of the actual diagnosis, and who aren't RUDE in guiding newbies on the rules of posting here. You nice people have given me a lot to think about and a lot to follow up on, which will hopefully help me to figure out what's going on with me. I wish you nice people all the best! =)
  15. vannafeelbettr

    vannafeelbettr New Member

    Acidophillous is a great probiotic which will aid with proper food digestion in stomach. it also helps protect healthy bacteria in your intestines. My capsules are refrigerated and I need to take 1 half an hour before my meals.

    Turmeric (an herb I use in tincture form) stimulates secretion of bile, eases stomach pain, and is a great antioxident and antibacterial supplement.

    I used to end up in ER sometimes in excrutiating pain because of digestive/bowel problems from painkillers. Since being on the acidophillous and turmeric, I have ZERO problems. No stomach discomfort, nice easy bowel movements.

    Good luck!!

  16. SkeptikSharon Please continue to post. There are always some rude people. Just ignore them.
  17. ellikers

    ellikers New Member

    vannafeelbetter ... I keep hearing more and more good things about probiotics! :) I have to say sharon that they helped me too.

    I'm also in support of you continuing to check in on these boards- I understand that people can be confrontational and argumentative here, I felt very similarly to you recently. I think the best thing for me at least is just check the threads you want to (and avoiding negativity elsewhere). Sometimes I have a hard time avoiding debates when I think I have good information or am feeling under attack, but it felt really good in the last week to just "walk away" (figuratively in my mind and physically away from the computer). I agree with you, boundaries are good and sticking to what you feel you need for mental health is also very important.

    Anyway, I hope to see you around talking and reading about what you want to. :)