If a person has a "sensitive stomach" and moderate chronic pain, what medicines (other than Tylenol) might be tried. Are there other ways to take medicine other than by mouth?
REPLY:
Medications can be taken orally, rectally, and absorbed through the skin in addition to intravenous and intramuscular routes.
Before considering rectal or transdermal approaches it is important to know that even taken this way some drugs can have gastrointestinal side-effects. Rectal drug administration is inconvenient and is often reserved for cases where nausea and vomiting limit the use of oral drugs. Some of the drugs taken in skin patch form are narcotics and can be habit forming. In addition, the use of these drugs can induce tolerance which means continued use seems not to have the same benefit as the body gets use to the drug.
Many medications can be taken in pill form if the drug is taken with meals and especially if it is available in an enteric coated form to minimize any chance of stomach or intestinal irritation. I would encourage you to explore this option with your physician and with your pharmacist in some detail. You might also look into prescription analgesics using propoxyphene (Darvon) alone or in combination with Tylenol (Darvocet) if this approach makes sense in your particular situation.
Finally you should consider non-medication approaches to chronic pain. Perhaps your situation would benefit from a referral to a regional or university center with a pain clinic.
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Bruce Sckolnick, M.D.
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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