PD and constipation

[Toby72]

Does anybody have information on the reason/cause of intermittent bouts of constipation in people with PD. All insight is greatly appreciated.

[Hidden]

I did not know it could be intermittent!

[Toby72 in reply to Hidden]

Yes. When it presents I can last for days on end and then just mysteriously resolve for days on end.

[Bodiepipe]

It's sucks, period.

[MBAnderson]

Like everything else, it'll probably get worse. I take psyllium fiber 3/day.

[Toby72 in reply to MBAnderson]

Thanks for your reply. That's what I'm also expecting. As a physical therapist working with a patient currently in this predicament, I am searching high and low for suggestions/solutions to partially alleviate this situation for my patient. Appreciate your time knowledge and understanding.

[alexask in reply to Toby72]

You should try mannitol. In some it improves symptoms as well as removing constipation for all

[AmyLindy in reply to MBAnderson]

Per day? Good for you-I need to be more disciplined like u.

[hopeful88]

The intestines are an involuntary muscle that pushes food along through the body. The intestines depend on your brain to regulate this movement of intestinal muscle. It seems that in PD, the brain's message to the intestines 'miss-fires' kind of like how the movement disorder aspect of PD occurs. This leads to a decrease in gastric motility and that means food takes longer to pass through the body. Why does the severity of constipation come and go? For the same reason that you have good days and bad days with motor symptoms.

The first thing to do is make sure you're drinking a healthy amount of liquids with your meal. Adequate water intake with your meal (along with good hydration in general) ensures that food can be broken down more easily and pass though more easily. The second thing that may help is something like metamucil (psyllium fiber). This stuff is actually healthy for the gut, but make sure you get enough fluids when taking it or your constipation may actually get worse. Finally, we don't know if medicines like stool softeners are safe over the long term.

The thing I find troubling about constipation in PD and related diseases is that, the more we do research on the gut, the more we realize that it's condition is tied to the development of different diseases, including Parkinson's. The gut has the highest concentration of immune (attacker) cells in the entire body, and thus if something should somehow get out of whack with your gut, bad things can happen.

The other thing is that neurotransmitters like seratonin are partly responsible for ensuring proper gastric motility so if you ever end up taking an antidepressant like fluoxetine (Prozac), you may notice an improvement in your constipation.

Finally, it seems that the peripheral nervous system that connects your brain to the rest of your body experiences some atrophy and decline in PD and related disorders. This means that the brain has more difficulty communicating with the intestines and the rest of the body. Strategies to boost production of nerve growth factor (NGF) may over time help improve issues with constipation, as NGF causes the regeneration of these peripheral nerves.

Exercise is ONE thing that will boost production of NGF, along with boosting other highly beneficial trophic factors like GDNF and BDNF. This plays a role in how exercise will slow progression of PD, if you do the exercise long term.

[Toby72 in reply to hopeful88]

Bless you hopeful88. Excellent insight and explanation. Thank you.

[ddmagee1 in reply to hopeful88]

Excellent cerebral explanation, answering the role of PD in constipation.

[AmyLindy in reply to hopeful88]

Great stuff - thx for articulating and educating.

[Josephsimon]

My husband gets badly constipated if I don't stay on top of it. I get him Exlax and he gets a good supply of coconut oil each day. Works for Louis. Good luck.

[alexask in reply to Josephsimon]

Have you tried mannitol?

[MBAnderson in reply to Josephsimon]

Laxatives for more than a week or two are a major no no. It's real easy to research it. Every website says the same thing. Zero disagreement on this.

[TimbTimb]

My wife, 3 years DX early onset at 36 was always constipated. We cut gluten from our diet and she is now regular as clockwork, almost happened over night. Also avoiding gluten free substitutes like bread and cakes etc. I also used to have the opposite problem with intermittent IBS, that has gone too.

[SELFMeder]

I solved this nagging and painful problem once and for all by taking one recomnended dose of Miralax each morning and one capsule of Colace each evening. Both are over the counter compounds in the US which my internist said were safe to use indefinitely.

[AmyLindy]

Good topic- This Shit Matters !

[nelo23]

I had constipation problems many years before I was diagnosed. Also lost my sense of smell many years before. I call them my earliest symptoms of PD.

[Igiveupxyz in reply to nelo23]

I too lost my sense of smell about 10 or 12 years before being diagnosed. As soon as I was on full dose of l-dopa three times a day, my sense of smell came back so now I know that that was an early sign

[mblongdon]

I have been constipated most of my life it seems. I didn't always follow a very good diet but even after I cleaned up my diet completely ( I do a keto diet and organic now) it didn't totally handle it, although it was much better. I think the damage was done. What I worked out is using Swiss Kriss, 4 tabs at night and then I use a glycerine suppository in the am. The Swiss Kriss helps the colon spasm so start slow because it can give you cramps but I have been doing this for 5 or 6 years. Its the only thing that ever helped.

[Toby72 in reply to mblongdon]

Thank you

[GerryWolke]

I take 2 Tri-Magnesium 2 out of three nights. It does a good job but taking it every night causes loose stools.

[M_rosew]

Constipation can be kept at bay with high fibre diet and water. eg. high fibre cereals, wholemeal bread, vegetables (leave potato skins on), salad, fresh fruit, dried fruit (sultanas, prunes etc). Drink a lot of water, with meals and when taking tablets.

[Astra7]

I think the muscles that cause peristalsis get weaker, and also mucus membranes get dryer (especially if taking NAC I believe). Also might be poor gut flora.

I sorted mine with 7 serves of veggies a day. quite a challenge (soup is helpful), and if I lapse I notice straight away.

I also took a range of pre and pro biotics and reduced gluten, dairy and eggs to make my gut a happy place for the good bacteria!!

[johntPM]

Let's be clear what I'm talking about: regularly going 4 to 8 days without defecating, up to 24 hours stuck on the toilet, then a monumental strain to make anything move, sometimes the faeces gets stuck, leaving the sphincters open, causing me to be temporarily faecal incontinent. I'm not talking about how to avoid it - I don't know.

Here's what I do if I really need to go:

1. Drink 2 sachets of Movicol (polyethylene glycol) dissolved in a pint of water.

2. Drink a pint of warm orange juice.

3. Although the official advice is not to use them, take a water enema.

Repeat at hourly intervals, no more than four times.

It's useful to weigh yourself before starting and after each cycle.

Constipation is listed as a side effect of levodopa/carbidopa. In spite of this, I find it useful to take my doses as usual.

John

[Trenny]

Try Laxido.