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This is a sponsored post. Salix Pharmaceuticals compensated me for this post. All opinions are my own. Certain product information has been included to meet regulations.

Having been a communicator for most of my career, I understand the importance of words. Having been diagnosed with RA for almost a decade, I know that the words we use with our doctors are crucial.

Doctors are used to hearing about pain in a clinical setting. However, Salix Pharmaceuticals took that discussion out of the medical facility and put a very personal and graphic twist on the conversation. Salix brought chronic pain patient influencers and health care providers (HCPs) together at a recent forum to discuss opioid induced constipation (OIC) and specifically the features, benefits and risks of Salix’s OIC treatment for appropriate patients.

 A linchpin of the discussion was the results of Salix’s survey done in partnership with the U.S. Pain Foundation (discussed further below). The patient influencers were asked to interpret the personal meaning of these statistics into artwork. The fact that these images were then shared with HCPs is, to me, incredibly powerful. This was a new way to see the issue; not a typical discussion with a patient. The artwork pieces were tangible interpretations of OIC statistics created by people who live with chronic pain. I believe this kind of interaction helps break down the communication barriers between HCPs and patients and can bring a much better understanding about OIC and its effects.

Patient influencers transformed statistics into meaningful artwork that was shared with healthcare providers.

While I’ve researched both pain statistics and the opioid “crisis” situation, I’ve only paid slight attention to OIC. I’ve had the occasional (really awful) experiences with OIC while on opioids and that’s convinced me to avoid the subject as much as possible. I do know that OIC is a significant issue for many people, complicating the lives of patients already living with chronic pain. I was therefore surprised to read some of the information revealed by the survey.

  • 77% of these patients reported suffering from OIC for at least one year.
  • 53% of these patients said they would have preferred for their OIC medication to induce a bowel movement in less than 4 hours.
  • These patients reported waiting an average of 18 hours to have a bowel movement after taking their constipation medication.
  • 47% of these patients reported taking between 6 to 10 total prescription medications on a regular basis.
  • 20% of these patients reported taking more than 10 prescription medications on a regular basis.
  • 37% of these patients reported changing the dosage of their opioid medication to try to alleviate the pain or discomfort from OIC.

In addition to the incredible artwork created for the forum, attendees heard from Dr. Joseph Pergolizzi, Senior Partner & Director of Research, Naples Anesthesia and Pain Associates, who talked about open discussion between patients and doctors about OIC. Dr. Pergolizzi said, “Some patients may not mention opioid induced constipation with their practitioner, so we need to have a ‘do ask, do tell’ policy. It’s important to realize that it starts with conversation. I like to use the phrase ‘Painstipation.’ These are chronic pain patients who are experiencing constipation due to their opioids.”

So thank you, Salix, for opening the dialog between patients and HCPs and providing an original method of communication via pain(tings). I’m glad I learned about “Painstipation”. I just hope I don’t ever have to use it in a sentence with my doctor ever again.

If you are experiencing Painstipation, please don’t be shy about talking to your doctor. There is help available and an OIC treatment such as Salix’s treatment RELISTOR® (methylnaltrexone bromide), may be right for you.

Note that I was invited to attend the Salix Pharmaceuticals forum but, due to shoulder replacement surgery, I was unable to attend.



  • RELISTOR® (methylnaltrexone bromide) is a prescription medicine used to treat constipation in adults that is caused by prescription pain medicines called opioids.
  • RELISTOR tablets and RELISTOR injection are used to treat constipation caused by opioids in adults with long-lasting (chronic) pain that is not caused by active cancer.
  • RELISTOR injection is also used to treat constipation caused by opioids in adults with advanced illness or pain caused by active cancer and who need increases in their opioid dose for pain management.


  • Do not take RELISTOR if you have a bowel blockage (called an intestinal obstruction) or have a history of bowel blockage.
  • RELISTOR can cause serious side effects such as a tear in your stomach or intestinal wall (perforation). Stomach pain that is severe can be a sign of a serious medical condition. If you get stomach pain that is severe, does not go away, or gets worse, stop taking RELISTOR and get emergency medical help right away.
  • Stop using RELISTOR and call your healthcare provider if you get diarrhea that is severe or that does not go away during treatment with RELISTOR.
  • You may have symptoms of opioid withdrawal during treatment with RELISTOR including sweating, chills, diarrhea, stomach pain, anxiety, and yawning. Tell your healthcare provider if you have any of these symptoms.
  • Tell your healthcare provider if you have kidney or liver problems.
  • Tell your healthcare provider if you have any stomach or bowel (intestines) problems, including stomach ulcer, Crohn’s disease, diverticulitis, cancer of the stomach or bowel, or Ogilvie’s syndrome.
  • Tell your healthcare provider if you are pregnant or plan to become pregnant. Taking RELISTOR during pregnancy may cause opioid withdrawal symptoms in your unborn baby. Tell your healthcare provider right away if you become pregnant during treatment with RELISTOR.
  • Taking RELISTOR while you are breastfeeding may cause opioid withdrawal in your baby. You should not breastfeed during treatment with RELISTOR. You and your healthcare provider should decide if you will take RELISTOR or breastfeed. You should not do both.
  • Also, tell your healthcare provider about all of the medicines you take, including prescription and over the-counter medicines, vitamins, and herbal supplements.
  • In a clinical study, the most common side effects of RELISTOR tablets in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, diarrhea, headache, swelling or a feeling of fullness or pressure in your abdomen, sweating, anxiety, muscle spasms, runny nose, and chills.
  • In a clinical study, the most common side effects of RELISTOR injection in people with long-lasting (chronic) pain that is not caused by cancer include: stomach-area (abdomen) pain, nausea, diarrhea, sweating, hot flush, tremor, and chills.
  • In clinical studies, the most common side effects of RELISTOR injection in people receiving treatment for their advanced illness include: stomach-area (abdomen) pain, gas, nausea, dizziness, and diarrhea.

You are encouraged to report side effects of prescription drugs to FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.

For product information, adverse event reports, and product complaint reports, please contact:

Salix Product Information Call Center
Phone: 1-800-321-4576
Fax: 1-510-595-8183
Email: salixmc@dlss.com

Please click here for full Prescribing Information for RELISTOR tablets and RELISTOR injection.