combination may be the soultion
Welcome to XXXXXXX Thanks for your query.
Bowel dysfunction, especially opioid-induced constipation
is one of the most common and persistent side effect in treatment of moderate to severe chronic pain
with opioid analgesics.
This results in low treatment efficacy and treatment compliance. Patients are exposed to additional burden and stress
Recent studies shows patients receiving a combination of Oxycodone/naloxone. the pain severity level was progressively reduced, at the same time bowel function was improving and overall patient satisfactions was increased.
I'm mentioning this because you have tried most of the other options available.
Discuss with your doctor about the above mentioned combination to help you with management of pain and constipation.
Hope the answer helps you.
Let me know if there is any clarification.