Problems with doctors and pain control

[nevilletanner]

hello all,

at the moment i am getting huge amounts of pain from the crohns, just has a ct scan and its showing that i have 15cm of narrowing at the ileum and a few interconecting fistulas in the same area, one of the fistulas has connected to the colon and the other has connected to the small intestines.
There is alos bad fistulation in the colon where the connection is and there is also signs that there has been perforation where small abscessess have formed but are not growing.

the problem i have at the moment is the bloody doctors will not prescribe anything stronger than dyhydrocodeine even though i have been taking 2x30mg DHC and 2 x paracetamol , i have had better results switching to tramadol but even so when the pain is bad i cannot even get out of bed without help.

has any one else had problems with there GP not allowing stronger pain meds ?

 

[valleysangel92]

Hello , I'm sorry to see you are struggling with pain .

Unfortunately, it does seem quite common for GPs to be reluctant at prescribing pain meds. One of the reasons for this is that drugs like codine and tramadol can very quickly cause addiction and dependency, so there are very strict guidelines regarding their prescription. Also, both tramadol and codine can slow the digestive tract down and cause constipation, which can result in blockages in those with crohns if there is a stricture.

I understand how frustrating this is, I have also been having high levels of pain recently, and have only just got a prescription for cocodamol (8/500) . The unfortunate thing for us is that GPs also have to be weary of stepping on the toes of our specialists, my GP will often refuse to get involved in something if I've already been referred to the hospital, but of course in the UK, hospital referrals can take 6 months or more, leaving us still suffering.

The other issue is that if we exhaust all the pain relief methods, we can end up with no options left for when we need surgery etc , so that also has to be avoided if possible.

I'm so sorry to hear your in this situation, I hope you get somewhere soon *hug* .

Are you currently on any medications to try and get the crohns under control? Is your GI aware of how much pain you are actually experiencing?

 

[nevilletanner]

my GP is fully aware of the situation as he is the one that ordered the ct scan.

as to pain killers - the 8/500 cocodamol you can get over the counter ( its the highest allowed in the uk).
my current ones are DiHydroCodeine 30mg X 2 every 6 hours with paracetamol aswell ( nearly 4 times stronger than cocodamol ) but i have found that if i alternate every few days between DHC and TRAMADOL i get better results.
I dont take them every day - only for the pain as i am very aware of the addiction problems codeine can create.

guess its a case of grin and bare it . think i might go back on the pred for a month and see it that helps.

 

[valleysangel92]

I know you can get the cocodamol over the counter, but I can't afford to since the closest pharmacy to me that sells them costs me £7 in bus fare to get to, plus the cost of the tablets... I have got tramadol on prescription (from before my resection) but they make me too drowsy sometimes. And as you say aren't appropriate for constant use. The only other thing my doctors will give me is cocodamol and that was with me practically begging because I've not slept in over 3 weeks from pred + pain
I know you are aware of the addiction risks, most patients are far more aware than doctors give us credit for to be honest.


Do you have an IBD nurse you could contact? They may be able to suggest a combination
of meds or other things that you could use. Most GPs I've seen will happily prescribe if it's been cleared by the IBD nurse.