Tramadol & Digestive Issues

Treatment and medication
1

Hi All,

I have been around the forums for a few weeks now and thought I would ask a question, I know I am a complex case compared to most, even my doctors and consultant’s agree! lol

The Summery

In January 2012, I stayed in hospital for nearly a month having two major operations, of which nearly killed me. Doctor’s even now are puzzled how it even happened in the first place – but, I am taking medication, and have been for over 25 years. Surgeons removed part of my intestines (approximately 50cm) on the Tuesday which was gangrene, but instead of recovering I became worse and by the Thursday they rushed me down to have further surgery, they told my wife to be prepare herself for the worse. After spending another 7hrs in surgery, I eventually came around, which shocked everyone considering I did not have time to even sign the consent form for the operation – basically, I was dying from the inside out and any part where the intestine touch also started to turn gangrene.

I was bed-ridden for 2 weeks and could not eat or drink, everything had to be done intravenously, including all medications. During this period I lost a few stone in weight, and eventually got back on my own 2 feet so to speak, and returned home. It took me months to even start eating again properly. The hospital said I would be looking at around 10 months to fully recover.

I had a colonoscopy done last December, but the hospital lost some of my records. Then they phoned me asking why I didn’t attend an Oncology appointment, but what they had done was put the both appointments together, without informing me. I got that sorted out and currently in my 6th of remission of testicular cancer which was positive back then. I did not even know they were checking for cancer when the colonoscopy was arranged, I was informed they were looking for an issue that was causing severe diarrhoea, but not all the time. But that turned out to be I cannot take any painkillers with codeine in them. Paracetamol was useless as a painkiller, even I did take 8 a day.

Doctors could not figure out why I would be constipated one day, very diarrhoea the next – they prescribed Loperamide 2mg to be taken one daily when required.

The Main Question

Now, this is what I do not understand – I was put on Tramadol 100mg a day for pain relief with Botox every 3 months and Madapar on a daily dose. A few weeks before I was also put on Amitriptyline. I have read on both of these medications that they can cause constipation and Epileptic Seizures, and I suffer from both, yet my stomach problems have calmed down and I did have seizure on Monday evening but it was not Epileptic, it was classed as a ‘Functional Episode’ which is similar in many but does not show up with any readings on an EEG test.

If anyone has experienced anything like this with Amitriptyline and Tramadol and any stomach issues I would be interested to know.

Regards,

Les.

2

Oh Les - am so sorry to hear what you've been through! But, somebody must love you upstairs or you wouldn't still be with us

Now, Amatripine us actually an anti-depressant (not a "pain killer" - which a lot of people are given it for!) And, Tramadol is another story - brilliant pain killer but, makes you very, very tired (and, you're on a high dose!) and, a b****d to come off of!

I suggest you discuss these issues with your GP  - explain to him/her how you're feeling.

If they're worth their salt, they will listen!

Let me know how you get on.

Zoe x

3

Hi Zoe,

Some of the things I have been through in life, many people ask how I coped - I guess having a sense of humour as a lot to do with it! biggrin  Having to stay in hospital and having so many intravenous drips blew all but one vein, my arms were black and blue from all the bruises. Zoe, I must correct you on one thing, we do not have an "upstairs", we live in a bungalow which is all on the level. LOL wink

I know Amitriptyline is given as an anti-depressant, but in some cases where the nervous system is involved it is actually given as a painkiller. I thought it sounded stupid at first, but it did have some effect in my neck where I Botox injections every 3 months (The problem with Botox is it is administered every 3 months, but is only effective for 2 months - there is a 2 week cut-in period and a 2 week cut-off period!). At the moment it is just a trial to see if they can remove Madopar 200mg/50mg from my list of medications, or at least lower it. If you look up Madopar you will see it is given to patients with Parkinson's disease, but it is also given to people suffering from Dystonic Symptoms.

The Tramadol is one drug, that I am unsure of - I know it makes me feel tired (works well when my wife is snoring! wink) and I get a good nights sleep, but what I do not understand is why I would need to take it in the day! I am in pain all day anyway, and Tramadol just sends me to sleep or put's me on a 'high'! Some people may like being on a high, but I'm not that sort of person, plus I like to spend time with the children (well, not little now, only my daughter is in her teens!) and be awake. Just last night I was sat at my desk, asleep and still clicking my mouse button, for some reason!!!

Discussing anything these days with all the cut-backs means I never get to see my own GP, shes only on part-time and I can never catch her at the right times. I even tried booking her online, not a single appointment was left in 4 weeks!! Perhaps, I need to try another approach. I have started to see a new doctor at the moment because they have to familiarize themselves with all my ailments. rolleyes

I will let you know how I get on, once I know.

Regards,

Les.

4

Although Tramadol is synthetic, it is still a defacto opioid. It works the exact same way, binding to the same receptors. This calms the muscle action in your intestines, which will tend to cause constipation. Your body then tries to compensate, leading to irritable bowel syndrome. If the Botox is being applied to intestines or bowel, it will paralize them. That will certainly cause constipation. Amitriptyline has a dehydrating effect, and that's going to contribute to the constipation, too.

By the way, if the Madopar causes you eye problems (due to high intraocular pressure) look into cannibis therapy.

5

Hi thebird55,

Strange thing is I have had no problems with the bowels since being on Tramadol. Botox is only applied to my neck left and right (to the muscle tissue behind the back of each ear, I can actually hear it being injected - not a nice feeling either). If Amitriptyline has a dehydrating effect couldn't I just drink more fluids per day? or doesn't work that way?

I cannot say if the Madopar causes eye problems, I wear bi-focals anyway and have done since my early 40's. Cannibis therapy? Isn't that illegal in the UK? Cannibis is the same as weed isn't it, thats a smell I cannot stand when stuck in shop queues.

Regards,

Les.

Regards,

Les.

6

Now I'm wondering if you problem was that your event triggered overactivity of your bowel, and the constipation was your body overcompensating. That would explain why the meds are actually helping. It's a little strange how all that works, as the stomach has it's own, independant nervous system. ( http://en.wikipedia.org/wiki/Enteric_nervous_system )

Yes, it's a good idea to keep your fluid intake elevated whild on these meds. It will help, but you may still have some drying efffects. Especially dry mouth (and don't underestimate the problems that can cause).

High intraocular pressure can lead to glaucoma, and there may be no symptoms to alert you to the problem until it's too late. You may want to have a simple test done occasionally, especially if you are over forty. (That's a good idea even if you are not on meds.)

7

Oh, yeah...

There are ways to take cannibis without smoking it. And there are even forms of it that do not produce a "high". Although, I don't know if those forms would be effective on intraocular pressure. You have have to investigate.

8

my problem with tramadole it makes me sleep with heavy sleep syndrome

I am now being refered to respiratory plus sleep clinic here

My own Dr did not belive me for a long time still does not really beleive i think

but the heart dept has refrred me so hoping they will find out. in the mean time the sleep is randome every day. lately till about mid day or 11 am i get up about 7 and have breakfast then back to bed etc etc etc GRRRRRcCheers and hope you do get rid of it peter

9

My Doctor mentioned something about an 'overflow' - which is normally caused by surgery on the intestines or bowel. Basically, when I have severe diarrhoea, it is classed as overflow, and I'm actually constipated. I have been told to remove any medication like Loperamide, or codeine from use. So, I did which made no difference, yet Tramadol does which I don't understand since that states it can cause constipation.

Regards,

Les.

10

Your doctor probably is trying to cut back on medications that can constipate, while keeping you on one for pain, which you need. It's a "risk / benefit" thing..

11

I received a letter yesterday stating my medication is going to be reviewed under a new scheme between my GP and Consultant Neurologist. I am assuming they will be going through the whole lot of medications I am on and what they are for. I know they were going to start running various tests, to try and improve issues I have been having lately.

Hopefully, I will find out then what is going on.

12

That's good news disabled_les - hopefully they will get to the bottom of all this and get you on the right meds and run the right tests!

Hang in there!

Zoe