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What causes persistent loose stools after having Opium?

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Posted on Sat, 16 May 2015
Question: Difference between paregoric and Tincture of Opium For many yrs I have been successfully taking DTO at a higher than normal dose for 1/2 stomach loss of part sm bowel wa on J tube 5yrs very happy to be w/o that used to need frequent admits for dehydration current meds keeping me able to cope at home new ins does not want to cover Doc told me he tried everything available including paregoric which increased nausau My Dr willing to fight ins to keep me on current path

doctor
Answered by Dr. Prasad (7 hours later)
Brief Answer:
Not sure how we can help you...

Detailed Answer:
Hi,

As I understand from this post, you have had persistent loose stools probably due to rapid emptying (dumping syndrome) that developed as the result stomach and small intestine removal (it may have been better if you had provided the indication for stomach + intestine removal). And that they have tried multiple options and only diluted tincture of opium (DTO) worked. Now, your insurance agents refuse to pay for DTO scripts.
You are also looking to know difference between paregoric and tincture of opium.

1. It is indeed a very dangerous confusion and this confusion between paregoric and tincture of opium has led to lost lives on more than one occasion. Though the difference are subtle, current FDA regulations insists marking the label bold so as to prevent confusion. The main difference lies in the amount of opioid (morphine concentration) - tincture of opium is 25 time stronger and more potent / deadly than paregoric.

2. If my first assumption was right, you should discuss about acarbose and other means to improve (if not resolve) dumping issues with a gastroenterologist.

3. I understand your treating doctor is extremely helpful and is willing to fight against insurance authorities. I am not sure I can help him through online forum based on limited medical information. However I do pray that he is successful with his efforts.

Let me know if you need any other help.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Prasad (2 days later)
I have had no side effects due to the DTO and are very cautious in using it I write in a journal my amount and keep it locked up I get no altered feelings propbably due to the length of using it and my body being accusted to the dose I have many ongoing health issues and intead of being admitted repeatedly I fight with meds which keeps me home sick but home I have tried all other meds on the market and since I am stable with only periodically dumping symptoms and N&V episodes that last 24-48hrs of retching and torment The difference between now and a few years ago is a happy improvement I had my 1st surgery after walking into er w/H&H of 5/15 now that I'm older I can't take such low counts I appreciate you answer unfortunitly my comp crashed after I placed it hope you can answer this thx
doctor
Answered by Dr. Prasad (28 hours later)
Brief Answer:
How did the symptoms begin...

Detailed Answer:
From what I understand you have digestion issues- nausea, vomiting, retching and perhaps constipation. And this DTO helps you. Please be aware though its a diluted formula, it does have some addiction and tolerance. Though you report no addiction, I'm not sure of tolerance from your description.
However I'm not able to figure out how these symptoms begin? What was the indicaton for surgery? What specific remedies (if any) were tried?

Regards

PS: Apologies for the late reply. I'm out of state with fluctuating Internet. I shall try answer your next questions at the earliest.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Prasad (21 hours later)
This I partial history oringanal care was done in prestigious Hospital.cause bleeding ulcer that didn't respond to care and looked suspicious 1st surgery done by head of surgery with many w/o sideefects 1. billroth and vegomotomy then n&v &p started #2 thought gall bladder causing done 6 mths after 1st #3Increase inepisodes of dehydrationdue to protracted v, n, and agony #4 albumin went below 1 and weight dropped to 1oo (now 150) constantly admitted J-Tube 3rd surgery 6yrs torment constant bile leakage burning skin 3rd degree. Admit sbo and had incisional hernia fixed at same time Hernia repair didn't last long. During admit (J-tube dislodged and sb perforated leading to emergency surgery 3wks ICU and 3 wks surgical floor 2 central line infections rough go but great to have J-tube removed.Sixth surgery to repair a large incisional hernia w/ 8x10 mesh lasted 2yrs then bowel slowly slipped out and currently have another the size of a softball causing difficulty with lifting and doing everyday life tasks and increasing pain n&v At this point no surgeon will touch me unless emergency. Now see why we cope with meds to stay the hell out pf ER/admits. Have malapsortion, decreased albumin,iron,with infusions and blood trans. extreme fatique,loss of calcium causing severe osteoporis vomiting can break a rib My goal is to stay away from hosp and procedure. My ? is if my use of meds to stay home is wise.I wonder if if I wait to long?
Is ok to rely on meds to stay home even if I'm guessing if I'm in trouble? Can't acess iv anymore w/o ultrasound
doctor
Answered by Dr. Prasad (30 hours later)
Brief Answer:
Better to avoid any further surgeries

Detailed Answer:
Hi,

I see that you have undergone many surgeries by now. I doubt if any further surgery is going to help you.

In my opinion, it is wise to continue with the medicines and avoid surgery as much as possible.

Regards,
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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What causes persistent loose stools after having Opium?

Brief Answer: Not sure how we can help you... Detailed Answer: Hi, As I understand from this post, you have had persistent loose stools probably due to rapid emptying (dumping syndrome) that developed as the result stomach and small intestine removal (it may have been better if you had provided the indication for stomach + intestine removal). And that they have tried multiple options and only diluted tincture of opium (DTO) worked. Now, your insurance agents refuse to pay for DTO scripts. You are also looking to know difference between paregoric and tincture of opium. 1. It is indeed a very dangerous confusion and this confusion between paregoric and tincture of opium has led to lost lives on more than one occasion. Though the difference are subtle, current FDA regulations insists marking the label bold so as to prevent confusion. The main difference lies in the amount of opioid (morphine concentration) - tincture of opium is 25 time stronger and more potent / deadly than paregoric. 2. If my first assumption was right, you should discuss about acarbose and other means to improve (if not resolve) dumping issues with a gastroenterologist. 3. I understand your treating doctor is extremely helpful and is willing to fight against insurance authorities. I am not sure I can help him through online forum based on limited medical information. However I do pray that he is successful with his efforts. Let me know if you need any other help. Regards