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On suboxone for psoriatic arthritis. Kidney stones were removed and having bowel problems. What do you suggest?

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My husband has psoriatic arthritis and is on suboxone for pain (no preceding addiction to opiates). In July a chronic low back (disk) problem flared at the same time that he experienced urinary urgency and retention, and serious constipation. MRI at that time ruled out cauda equina, he was diagnosed with a kidney stone stuck in prostate area. This was subsequently removed, but since then urinary and bowel problems have persisted. Orthopedist sees no need to operate based on MRI, pain in back has increased. Last week pain specialist prescribed gabapentin, urologist suggested antibiotics. Today to emergency room for catheter. Should we consult a neurologist? Any other suggestions?
Posted Fri, 22 Nov 2013 in General Health
Answered by Dr. Rakhi Tayal 48 minutes later
Brief Answer: A nerve problem is likely. Detailed Answer: Hello, Thanks for trusting us with your health concern. The urinary retention and urgency that your husband is having can happen due to urinary infection or a mild nerve related problem. The urinary infection can be ruled out by a urine culture. Consulting a neurologist for the proper management is recommended. You can also get some muscle relaxants prescribed for the low back pain he is having due to disc prolapse. Decreasing the suboxone doses will help in relieving the constipation. Please feel free to discuss further. I will be glad to answer the follow up queries that you have. Wishing you good health. Regards. Dr. Rakhi Tayal.
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Follow-up: On suboxone for psoriatic arthritis. Kidney stones were removed and having bowel problems. What do you suggest? 25 hours later
Could a nerve related problem also cause ongoing severe constipation? He has never had this problem before, and the sudden onset of all three symptoms seems more than coincidence. Laxatives do not help, and only an enema was able to precipitate a bowel movement last week. If this is a nerve problem caused by a pinched never at L5, would a neurosurgeon be a better choice to consult than a neurologist?
Answered by Dr. Rakhi Tayal 22 hours later
Brief Answer: Neurosurgeon will be a better option. Detailed Answer: Hello. Thanks for writing again. A nerve related problem is less likely to cause this constipation. For any nerve related problems, you can consult a neurosurgeon. He will be a better option than a neurologist. Hope my answer is helpful. If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health. Regards
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