A PERFECTLY GOOD AND USEFUL POST FROM SOMEONE WHO HAS BEEN AROUND THIS BLOCK THREE TIMES

When I first had surgery no one told me this was a thing. It was 2015 and I had the surgeon go into my right knee and clean up my meniscus. It was minor, non-invasive, and recovery took about a month. Very simple. They gave me a super small amount of codeine, maybe 15 pills. I split them in half once I realised how wonky they made me feel. After three days, I realised my bowel movements weren’t happening anymore and I was feeling very uncomfortable.

At the time I was extremely active and ate a lot for weightlifting. I continued my diet the same way, so you can imagine how bloated and terrible I felt. I didn’t know what do to, so I started taking a stool softener. Laxatives were too harsh for me and reminded me of the days I had an eating disorder, so I avoided them.

What no one tells you is that stool softeners do not promote peristalsis. Peristalsis is the involuntary muscular movement of your intestines that pushes the bolus (post-stomach food blob) through the lower GI tract. This is what opioid use affects, and so while your stomach is doing a great job mixing it up and digesting, your intestines come to a full stop. It doesn’t matter how liquid or solid your stool ends up being in the colon, it will not move. Pushing does not help. As embarrassing as this is, I developed an external hemorrhoid from straining on the toilet. While I still have it, t’s not painful, it doesn’t get in the way, and I’ve kind of accepted it as “cute”. It’s like a skin tag or mole. I had a previous partner who was charmed by it call it my “notch” and I think of it now as a weird beauty mark. I hope this is not disgusting for anyone, but it depressed me for a long time to have before I accepted it, especially because surgical removal of external hemorrhoids is more pain and torture than just, having one, which does not cause any pain to me at all. Back onto the subject:

While laxatives and enemas are helpful as a short-term solution, they have a very, very harsh affect on the body. They are dehydrating (the opposite of what your intestines need, since the colon leeches water from stool), and they disrupt the normal function of your lower digestive tract. Laxatives cause intense diarrhea are also insanely unpredictable, meaning you could have one, and if it doesn’t work when it says it will, you’re caught with your pants down (sometimes literally, and multiple times within the hour).

Senna tea is the only thing that helped me with this. Senna is technically a natural laxative/stimulant, but when consumed as per instructions, it helps produce a perfectly normal stool on a fairly regular schedule. Once I started using it, my digestive system was acting as though it was almost back to normal. It does create a slight sense of urgency, meaning you might run to the bathroom in the morning, but not at all like a laxative pill does. The brand I use is Traditional Medicinals Smooth Moves tea. You’re supposed to have it just before bed. You brew it with boiling water, and letting it steep for 10-15 minutes. Once it’s done steeping, you have to squeeze out the bag like a little sponge and let it drip into the tea. It almost feels oily, kinda slick and weird, but it tastes good and it’s a really nice bedtime tea. You could probably put honey and lemon in it if you wanted.

Depending on the amount of opioids you’re taking, it might not happen right away, but be persistent. The tea instructs you not to take it for longer than a week, but that’s only because they’re assuming your constipation isn’t related to another medicine. If you have Crohn’s disease or IBS or any similar chronic intestinal issue, please talk to your doctor first. I am not a doctor. I am not in a medical field, I am a patient giving my first-hand experience. I’d say after the first two nights, you should feel like you need to have a movement. If your constipation continues, definitely see a doctor. Again, I am not a doctor, this is just based on my experience.

When your doctor prescribes you the opioids, talk to them about using senna to supplement your diet. My nurses always like to hear that I have a strategy and they seem to encourage the use of senna tea with opioids. In my experience, the best strategy is to start having the senna tea before bed the same day as you start your opioids, and see if it helps keep you fairly regular. You might not be as regular, it will not bring you to 100%. But you will experience relief and I think that’s really important to know. If there’s any debate, feel free to send me an ask and I’ll publish it for general knowledge.