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wieyedoc
wieyedoc, Board Certified MD
Category: Medical
Satisfied Customers: 11353
Experience:  Over two decades of clinical practice. Completed a medical internship in New York City
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I am currently being prescribed the following for

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I am currently being prescribed the following for osteoarthritis (moderate) and multiple left rib fractures from a fall in the bathroom which happened three weeks ago;the ribs are healing well, it seems to me. Most of the pain is from the arthritis. I get very bad constipation and wish to know which prescription you consider to be the most constipating of the ones below. I am supposed to take all of these but I sometimes forget, though I keep running out of morphene because when I get an attack of arthritis it is extremely painful.
1.10mg/5ml Morphene Oral Solution. I take 40ml per day in divided doses but normally 30ml before the accident.
2. Codeine 15 mg tablets. 60 mg a day in 2 divided doses.
3. Paracetamol 500 mg. Prescribed 8 a day but have cut it down to 6.
4. 1x200mg ibuprofen plus 1x20mg omeprazole twice a day with a meal
5. 2x 10mg Amitriptyline at night.
6. 2x 10mg Zolpidem at night.
7. 2x 10mg Temazepam at night.
8. 4x 5mg Diazepam a day as needed, for anxiety.
9. 2x 800mg Boswellia serrata per day. A supplement which I was advised to take by a rheumatologist.
10. Vitamin D-3 2,000 iu 1 a day
11. 1x400mg SAMe on empty stomach, first thing in the morning.
12. BuTrans 10 microgram/hour Transdermal Patch Buprenorphine patch, changed every 3 days.
The constipation is so severe that I take at least 12 dulcolax tablets twice a week to empty my bowels. After clearing my bowels I take Dioralyte sachets in water to replace lost water and body salts. Usually I take two sachets.
The constipation seems to make the arthritis more painful. When the bowels are empty the pain of arthritis lessens. Vigorous exercise makes the pain bad the following day.
I lose one or two days a week on account of constipation followed by laxatives and painful bowel movements. The hospital doctors noticed the constipation when they scanned me after the fall which broke my ribs. I have been given an appointment for a 'virtual colonoscopy' on the 12th September. I have another appointment in the outpatients dept. on 26th September for a review.
Submitted: 1 month ago.
Category: Medical
Expert:  wieyedoc replied 1 month ago.

Hi. My name is***** have over two decades of experience, and I'm online and available to help you today.

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Expert:  wieyedoc replied 1 month ago.

you should not vary your medication dosages based on how you feel.

Also, your constipation is made worse by your morphine, etc use.

You should discuss this in detail with your MD.

I am happy to be able to help you today. If you would be so kind, please help me get credit for my efforts in answering your questions and press the excellent feedback button for this encounter. And, don’t forget, I work for tips. I would also be happy to continue to answer any more questions you have until we have resolved your concern.

Dr. Rick MD FACS

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Customer: replied 1 month ago.
Dear Doctor,
There are a lot of medications here. I know that morphine contributes to constipation but to cut it out suddenly and completely would put me in considerable pain.
Before we go any further could you tell me whether morphine comes in different strengths? What strength is the morphine I am taking please? High or low?(After the multiple fracture I was put on 40ml a day and I have been tol to stay on that dose until the ribs are much better.) I am sure my own doctor would not object to my cutting down on something else.You say I should not base my medication on how I feel. What should I base it on then? I feel in a lot of pain. The medication is based on actual scans. These told the specialists that the pain was caused by arthritis, then I was put in more pain by the accident. The pain from that is temporary, I hope.What other drugs could be causing the constipation, in addition to the morphine? I would be more likely to succeed if I am advised to cut down on something easier than morphine. You have not specified what you mean by "etc". I need to feel I am succeeding in cutting down/out on something which is contributing to the misery of constipation. What is the easiest to begin with? Apart from the morphine I don't know what else is causing the problem. I can't co-operate with big changes right now. I am in too much pain.