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its not horrible but it's there. Metamucil caused gas and pain, Benefiber doesn't seem to help at all. I emailed Dr Shen today and asked about codeine and he shot that down saying too addictive. Damnit. I took Oxycodone off and on for several years prescribed by him and pain management. But he suggested maybe try opium tincture. Isn't that just as strong a narcotic as codeine if not more so?  After all I have been through I would think he would be on board to try and help me. I am feeling great and this is best I've felt in 10 years. Besides the leakage my pouch is working great. I'm just bummed he won't let me try the codeine to see if it might help. 

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What is your objection to opium tincture? It has less abuse potential because of the horrible taste and inconvenient liquid form. I am not implying that you are at risk for abuse. This is regardless of whether you were 100% compliant in the past, because the regulations are getting tighter and tighter. Codeine does have some abuse potential, although the "street cred" is not as high as oxycontin. Paragoric, not so much. I'd try it if I were you.

Unfortunately, addiction and death associated with prescription opiates have led to extreme inconvenience for patients in need.

I presume you've tied lomotil?

Jan

Last edited by Jan Dollar

I have never tried Lomotil but isn't that like Imodium? It's a bowel slower transit, not really a thickener? I don't have a transit issue. I'm not always going. I have heard Shen is against that too. I have never seen or heard of paregoric?? I took tincture opium a long time ago. I remember I could only get it at Cleveland Clinic main campus pharmacy and it was a pain in the but caring it around. I guess I can try it, it won't hurt. 

Lomotil works in a similar way to Imodium, but is stronger. It is prescription only. Both Imodium and lomotil act upon the opiate receptors in the gut, same as codeine and oxycontin. Tincture of opium is Paragoric. Same thing. 

It is unclear to me why you differentiate bowel slower and thickening agent, when you are wanting codeine (an opiate), which is not a thickening agent, but a bowel slower.

Yes, Paragoric/opium tincture is available by special order only. I don't think any pharmacy keeps it in stock.

Jan

Last edited by Jan Dollar
Jan Dollar posted:

Lomotil works in a similar way to Imodium, but is stronger. It is prescription only. Both Imodium and lomotil act upon the opiate receptors in the gut, same as codeine and oxycontin. Tincture of opium is Paragoric. Same thing. 

It is unclear to me why you differentiate bowel slower and thickening agent, when you are wanting codeine (an opiate), which is not a thickening agent, but a bowel slower.

Yes, Paragoric/opium tincture is available by special order only. I don't think any pharmacy keeps it in stock.

Jan

I read numerous threads here saying people with leakage issues have tried codeine with success, that's why I was inquiring about it. Don't opiates thicken stool, I have heard people on them get constipated. Isnt constipation a stool that gets to thick? are you saying that a bowel slower and thickener is the same thing? getting confused now.

No, opiates are not a stool thickener. Thickeners are things like Metamucil and pectin. Opiates are bowel slowers. They can treat diarrhea and cause constipation by slowing the gut. When the gut is slowed, it allows more time for water absorption. Constipation is an infrequent, firm, dry stool that is difficult to pass. 

Imodium and lomotil are synthetic opiate derivatives that do not act on the central nervous system opiate receptors. They work only on the gut opiate receptors. Thickeners like fiber supplements work like cornstarch in a pudding. They create a colloidal suspension that hold water. This relieves constipation by holding water in the stool, and relieves diarrhea by absorbing the water in the stool. They do nothing to slow the gut. Lomotil is a controlled substance too, but not restricted the same as pain relieving opiates.

Jan

Wow, thanks Jan. I got world of information on how lomotil, imodium and stool thickeners work in the body in one single message of yours That's awsome!

BTW, Lomotil is prescription only in Turkey too, although it's not difficult to get one from a GP. However, my personal experience with Lomotil did not show any superiority over Imodium in the past, so I no longer bother it. 

Pouchomarx, I agree with Jan on trying Tincture of Opium. I think you could give it a shot again. You guys at least have this option in the US...

Stay well,

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