Question: Seeking Advice on Pain Medication for Ostomy Patients

One of our patients has expressed concerns about pain medication not dissolving effectively, leading to almost whole pills being visible in her stoma output. She is seeking advice on pain medications that dissolve better and faster, without affecting her stoma output.

Response: Recommendations for Optimal Pain Medication Absorption in Ostomy Patients

It’s essential to consider certain factors when selecting pain medication for ostomy patients. Firstly, be aware of medications that might alter stoma output in terms of color, pH, or quantity. Inactive ingredients and absorption issues should also be considered.

Alternative routes of medication administration, such as transdermal, buccal, subcutaneous, sublingual, intravenous, or intramuscular, can be more effective than oral methods. For instance, B12 injections can bypass the digestive system, offering better absorption without impacting the stoma.

It’s advisable to avoid extended or sustained release (SR) pain medications, such as MS Contin, Dilaudid SR, or Oxycontin. These medications are designed to release their active ingredients gradually, primarily in the colon, posing risks of improper dissolution and overdose if modified.

Immediate Release (IR) medications are preferred for their quick release and absorption. Liquid formulations, particularly sugar-free options, are generally better absorbed early in the digestive tract. Be cautious of medications containing FODMAPs or polyols like sorbitol, mannitol, malitol, and xylitol, which can cause diarrhea and affect stoma output.

Common pain medications like acetaminophen and ibuprofen (NSAIDs) are available in sugar-free liquid formulations. However, be mindful of the potential side effects of NSAIDs, such as discolored feces.

In conclusion, sugar-free liquid acetaminophen is recommended for pain management in ostomy patients. Other administration routes should be considered to avoid any impact on the stoma. Always consult with a healthcare professional, like a pharmacist or doctor, before starting any new medication to ensure safety and effectiveness.

Dr. Shabita Teja, BSc (Pharm), ND
Sinclair Wellness Centre
Contact: shabita@tejawellness.ca | Mobile: 778.552.4580
Office: 604.629.1120 | Fax: 604.683.2565
Unit 228-757 West Hastings St, Vancouver BC V6C1A1
www.sinclairwellness.ca

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