Remedies for Parkinson's constipation - Cure Parkinson's

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Remedies for Parkinson's constipation

park_bear profile image
114 Replies

This subject comes up a lot, so I figured it would be useful to post our collective wisdom in one place as a reference. As usual – what works for one may not work for another. So members of our club are invited to also post your remedies in the comments.

The causes of Parkinson's constipation

There is more than one cause. First, muscle activity of the G.I. tract tends to become weakened – this can include difficulty swallowing, gastroparesis, and in the matter at hand, sluggishness.

The G.I. tract also tends to get dried out, from one end to the other. This can include low saliva, food or pills getting stuck in the esophagus, and inadequate moisture and lubrication for expelling the waste.

Solutions

I found that high-dose thiamine restored my normal G.I. tract peristalsis within a week or two. I have also observed that too much thiamine can result in discomfort - excess peristalsis when none is appropriate. So it took a bit of experimentation to get the dosage right. Personally, 500 milligrams of thiamine HCl is right for me, but this number is different for everybody. The protocol for high-dose thiamine is set forth here: highdosethiamine.org/

To restore moisture content I used 5 to 10 grams of vitamin C, mixed in drink, over the course of the day for some time. More recently 1-2 grams has been sufficient. I am sensitive to acid, so I use calcium ascorbate. This is about 10 percent calcium by weight. The stool softener known as docusate sodium can also work for this purpose.

I have recently noticed that consumption of MCT Oil has a lubricant effect. I use it in place of butter. I have not been scientific about measuring my consumption, but my guess is I consume about a tablespoon or two daily.

Having made these changes I can report I have not experienced constipation for some time and my bathroom duties are quick and efficient.

What works for you?

---------------------------

Update 5/18/24. From a recent study: medrxiv.org/content/10.1101... "Interestingly, we also observed strong opposing effects for two laxative agents commonly used to treat constipation in PD patients. Macrogol (polyethylene glycol), was significantly associated with increased disease severity (+0.34, P<0.001), while ispaghula (Psyllium), a dietary fiber, was associated with decreased disease severity (−0.42, P=0.0004)."

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114 Replies
simonasays profile image
simonasays

Thank you for this.

I'm a pelvic floor physical therapist and have treated constipation in Parkinson's a few times and they are the most difficult to treat. One thing that helps (though needs to be used in conjunction with other methods) is putting a heating pad on your belly and performing the ILU massage to stimulate colon motility right after. here is a link: covidphysicaltherapy.org/vi.... Activity is also very important. If we do not move / walk adequate digestion is difficult. If you have a caregiver and cant do the massage on your own, caregivers can do this.

The squatty potty is also helpful because it straightens your rectum and there is less of a need to strain. I know straining is sometimes unavoidable, but overtime it does weaken the sphincters and makes them uncoordinated (causing more elimination problems)

Just a note about senna and other "stimulant" laxatives: the body can become quickly dependent on them, so they should be used sparingly. I have had many patients come in who basically are addicted to them and the colon essentially has become more sluggish and waits for that stimulant in order to eliminate. The stimulation of these laxatives also cause the sphincters to become dysynergistic over time. Osmolaxatives are more gentler and soften stools which makes them easier to move down the tract. Personally overdoing the osmolaxatives is better than using the stim laxatives.

Two things that have helped (not cured) parkinsons patients is IBGard (found in pharmacies) and eating two green kiwis a day. The enzyme in the kiwi improves colon motility,

Lastly, if you are having pain when defecating, your poop is coming out skinny or you suspect the anus itself is not opening to get the poop out, it is different than standard constipation and one needs to correct the outlet dysfunction before addressing the other parts of the digestive system.

park_bear profile image
park_bear in reply tosimonasays

Thanks for your extensive comment including adding the warning about senna. Accordingly, I deleted the reference to senna in my post.

I found that a footstool in front of the toilet works better for me than the squatty potty.

I see that the active ingredient in IBgard is peppermint oil. I tend to hold tension in my gut. On occasions when this bothers me I use this enteric-coated peppermint oil product:

amazon.com/gp/product/B0002... Also just a drop or two of peppermint oil mixed in with morning oatmeal can be helpful for that as well.

simonasays profile image
simonasays in reply topark_bear

If someone is backed up for days and feeling ILL - i will tell them to go ahead and use the senna because you dont want to become impacted. but if you find you need to use them once a week more often, I would say double your dose of colace or miralax before you regularly reach for the senna.

Yes, i sometimes stick to the brand name just because i know it works and just want to recommend the "sure thing" but i will tell my patients from now on that if they are tired of spending the $ on IBgard to try the solar ray. The other thing about IBgard it says there is fiber as well, but it does not list it in the ingredient list which i find strange.

And before buying squatty potty i will tell people to play around with positioning stacks of books or small step stools to see which height and foot positioning works well for them :-)

i think a lot of times people focus on the intestines and it can be other factors - that "tight gut" can also mean abdominal muscle stiffness in which case massage / heat can be helpful. When you are more of a chest breather the top of the colon gets stiff because the diaphragm is also stiff from lack of belly breathing and they kind of just adhere together. softening the belly manually with massage and heat and practicing diaphragmatic breathing can improve motility as well over time. Also, using a massage stick up and down the gut can help too. when i feel tension in the gut in a patient, i think - how can the colon work optimally when there is all that gas an tension occupying space?

My husband went on a keto diet for a few months (not sustainable) and he did mention MCT oil made him run to the bathroom regularly so i did think it may be helpful for other uses but it slipped my mind. will have to see if it helps my patients and my dad!

Yaya29 profile image
Yaya29 in reply tosimonasays

MCT oil works well. Also I find apples useful

bigl62 profile image
bigl62 in reply toYaya29

How much mct oil do you take?

Smittybear7 profile image
Smittybear7 in reply tosimonasays

how much MCT oil do you recommend?

OAFC profile image
OAFC in reply topark_bear

Senna tea works for me but should I stop using now as per simonasays advice ??

park_bear profile image
park_bear in reply toOAFC

I would try the high-dose thiamine first before abandoning what is working for you now.

Smittybear7 profile image
Smittybear7 in reply topark_bear

I currently take 500 mg of B1. The Nutropath I’m working with so I should be taking four times that amount. I’m having real problems with constipation was just in the ER last week. They told me to take.Bicol ec, hyoscyamine sulfate for gas and cramps, misled, and docusate sodium twice a day. Ct scan showed all organs normal and no blockages. Experiencing a lot of gas and cramping and have not started h mm taking the prescription for gas and cramping because I’m afraid of the side effects. Any suggestion would be appreciated thank you in advance.

park_bear profile image
park_bear in reply toSmittybear7

If you have already established 500 mg of thiamine HCL is right for you I would leave that dosage alone.

According to drugs.com/dosage/docusate.html you can take up to 400 mg of docusate sodium for constipation, Since you're having trouble I would recommend around 200 mg docusate sodium daily. I would also recommend a couple of tablespoons of MCT oil daily, and a couple of grams of vitamin C daily. When you start to experience loose stools then cut back on the above. It is not necessary to take all these different ingredients if there's something that does not agree with you.

I take it the hyoscyamine was prescribed for the cramps. Be aware it can aggravate constipation. If it is helping you I would continue, if you can get the constipation under control with the above measures.

Smittybear7 profile image
Smittybear7 in reply topark_bear

thank you for your help! Hope you’re doing well!

Smittybear7 profile image
Smittybear7 in reply topark_bear

The recommendation for 2000 mg of b1 was based on extensive blood tests. I am unsure of taking that much even though it was suggested to gradually increase the amount. I have been taking 500 mg b1 for a long time. I haven’t been able to establish b1 for Parkinson’s because of all the health issues I have. So I’m confused. Thanks for your help!

simonasays profile image
simonasays in reply toOAFC

sorry I realize this is old but I want to respond in case. Senna is a stimulant and therefore like any stimulant it is habit forming. Much like that cup of coffee in the morning that you need to wake up and the withdrawal that might come from quitting coffee. this doesnt mean you should stop. It means, you need to make the right decision for YOU with this in mind. I usually tell people try the other things first - get enough fiber, try osmotic laxatives before stimulant ones. In the end we need to poop.

Bunny622023 profile image
Bunny622023 in reply topark_bear

That's a shame you have deleted Senna parkbear.

Glenfarclas profile image
Glenfarclas in reply tosimonasays

Hello I realize this post is quite old. But I had question. I’m positive I have an outlet dysfunction issue. I exhibit all those symptoms. Painful poops thin poops tight anus. It’s like my muscles won’t relax or cooperate. It’s even hard to pass gas. Are there any online resources available that can help me treat this outlet dysfunction issue? I’m in So much despair over this problem. I’m not sure if there are any specialists in my area either.

simonasays profile image
simonasays in reply toGlenfarclas

Hello Glenfarclas where are you located? My first recommendation is working with a pelvic physical therapist

Glenfarclas profile image
Glenfarclas in reply tosimonasays

Thanks for responding. I’m located in Toronto Canada.

MBAnderson profile image
MBAnderson

Thank you p_b & simonasays.

Jennyjenny2 profile image
Jennyjenny2 in reply toMBAnderson

So pleased to see your reply, Marc!

Hope all went better for you than expected🌸

MBAnderson profile image
MBAnderson in reply toJennyjenny2

Thank you, Jenny. It went well.

park_bear profile image
park_bear in reply toMBAnderson

Glad to know that!

ParlePark profile image
ParlePark

Mct oil as well with Psyllium and flax seeds usually with oatmeal.

MissRita profile image
MissRita in reply toParlePark

how much of each? Also, what brand of MCT oil do you use and psyllium?

ParlePark profile image
ParlePark in reply toMissRita

stopped taking mct. However I use Yerba.com organic psyllium. Highly recommend it. It keeps me regular and very healthy. Recommended by consumer lab.com excellent product IMHO. PARK BEAR has an excellent thread on constipation. About a year ago or so. I’ll try to locate and send a link. I do use flaxseed (organic) as well from Amazon increasing fiber definitely helps. Lastly, squatty potty Amazon also helps Park Bear just responded Check it out Rita Thanks PB!!

For me Yerba psyllium definitely makes me regular, daily without laxative effects every once in a while I use a laxative but not often hope this helps

park_bear profile image
park_bear in reply toParlePark

This is that thread :-)

Jbeaner profile image
Jbeaner in reply toParlePark

When do you take the psyllium? After a meal I feel all the water will dilute stomach acid. Before meal I feel it will fill me up.

ParlePark profile image
ParlePark in reply toJbeaner

I take 1/2 C/L 25/100 at 0700. I eat and take meds at 0800- . Because I’m on C/L 50/200 ER it’s ok for me to eat when I take meds. However no protein. Mostly berries and oatmeal. I take my psyllium at 0930. Need at least 1 1/2 hours after meds. I sometimes take a 2nd psyllium at 430. Lots of fiber, flax, berries, etc. helps for me considerably.

Jbeaner profile image
Jbeaner in reply toParlePark

sounds promising.

kaypeeoh profile image
kaypeeoh

I have one dulcolax with lunch. Then generally I'll have a BM the next morning. But not always. Sometimes there's no sensation of a full colon. In chinese medicine the large intestine meridian is connected to the nose and sinuses. I found late morning or early afternoon I get congested. That's my cue to try for that BM. And in most cases it works. Sometimes I have to push on the transverse flexure on the left side below the belly button (Umbilicus) Typically there's one HARD stool that takes effort to remove. That's followed by soft, formed stool 4 inches long. That's followed by liquid mess known as fecus, digestive end-products waiting for fluid to be removed. Sometimes I'll snack on prunes during the day. If so the whole process happens faster.

More thoughts... the PWP can roughly be split into two groups - the newly diagnosed who are seeking answers and guidance, and the veterans who have the answers and can give the guidence.

And the former group is much larger.

So all veterans who want to get off the hamster wheel can decide to create their own single place (with the link found on the pinned post), and if the content is good, people will find it, and read it...

park_bear profile image
park_bear

That makes sense but such pinned posts need to be organized by topic not by person, which is exactly what I am attempting to do here.

Smittybear7 profile image
Smittybear7

Thanks for sharing. You provide so many helpful ideas and information. God bless you! Ileocecal valve rubbed clockwise AM and PM helps along with hydration and abdomen massage.

MarionP profile image
MarionP

Prune juice, or just eat a couple of RIPE pears, or mineral oil (which is usually edible, will say on label...low tech tried and true...in fact one mineral oil I saw at Walmart was in the pharmacy section, said mineral oil, and listed constipation as a reason for taking...mentioned dose too).

bassofspades profile image
bassofspades in reply toMarionP

Ancient wisdom -

He who eat many prunes sit on toilet many moons.

rideabike profile image
rideabike in reply tobassofspades

I think they work for me but I should eat more.

bassofspades profile image
bassofspades in reply toMarionP

I worked for a doctor that recommended mineral oil to a patient for constipation. "Lube the chute!", He said.

park_bear profile image
park_bear in reply tobassofspades

I use MCT oil for that purpose. It is reputed to have other beneficial effects.

gomelgo profile image
gomelgo in reply topark_bear

Mineral oil is not MCT oil? What do the letters stand for?

park_bear profile image
park_bear in reply togomelgo

Medium chain triglyceride

chartist profile image
chartist

I'm partial to the combination of high dose vitamin C and magnesium citrate capsules to get things moving and obtain the health benefits that both have to offer. Regular walking is helpful also, for those who are able.

I also find the dietary fiber that has inulin + FOS, very useful for constipation via the feeding of health promoting gut microbes, but not pathogenic bacteria. It also increases short chain fatty acids (SCFAs) which are generally considered to be health promoting. The three prominent SCFAs are propionate, acetate and butyrate. PwP are noted for having lower levels of gut SCFAs than healthy controls.

Art

Rather profile image
Rather in reply tochartist

Agree, Magnesium one or two pills a day helps loosen the muscles to get things flowing again.

Lyrics19 profile image
Lyrics19 in reply toRather

Are u talking about Magnesium capsules Citrate?

Zella23 profile image
Zella23

Lots of great info above, good thread Park Bear, as you say what works for one person doesn’t always help another but it might do.I have been researching about resistant starch and how including these foods can help your gut health. This is an interesting article about it.

healthline.com/nutrition/re...

We have added recommended foods to our diets and mostly it has really helped my husband.

Breakfast oatmeal and oat germ, with mixed fresh berries, dried apricots, green bananas, flax seeds, chia seeds, cinnamon and inulin which is from the chicory plant, coconut oil.

Lunch, varies but often veg soup, salad, whole meal bread, some protein.

Snacks on grapes and oranges, and apples in the day.

Dinner small amount fish/meat lots of green veg, asparagus, bell peppers, mushrooms etc (twice cooked potato)

Supplements include Mag Citrate, B1, vit D, vit C amongst a few.

rideabike profile image
rideabike

My small advice is avoid cheese. One piece of it (unless it's goat feta) just does me in for a week and a battle ensues with flax seeds and fibre, fibre, fibre, etc. Oh but I miss cheese but it's not worth the battle most of the time.

Alock2020 profile image
Alock2020 in reply torideabike

You mentioned that you still consume goat feta. In your opinion, is goat's milk less constipating than cow's milk? Trader Joe's carries goat yogurt (which I consume, thinking that it's beneficial. I still have a major problem with constipation.

rideabike profile image
rideabike in reply toAlock2020

Soft goat cheeses are ok for me and better than cow even soft cow cheeses. I love feta in salad and on pizza and stay away from any hard cheeses of either type. Mind you, fibre helps digestion and constipation and I’m eating more of it. Hope this helps you decide. I tried goat yogurt too but have a small amount of probiotic yogurt now and then. Plant yogurt made with oat is good and satisfies the appeal for something creamy. I should experiment with trying to make it. I can’t have gluten so it’s difficult to satisfy snacks and things.

gomelgo profile image
gomelgo in reply torideabike

As I was going vegan over a decade ago, it took me nearly a year to kick the cheese habit. I learned that milk container casomorphine (sp?)

It has actual morphine in it specifically to make it addictive to baby animals. This is why cheese is the hardest thing to give up.

park_bear profile image
park_bear in reply togomelgo

Skeptical. Do you have a link to support that idea?

gomelgo profile image
gomelgo in reply topark_bear

Very very googleable. Try it and if you find nothing let me know. Try "what is casomorphine and what is its purpose".

park_bear profile image
park_bear in reply togomelgo

recent research:

ncbi.nlm.nih.gov/pmc/articl...

"Food-derived opioid peptides include digestive products derived from cereal and dairy diets. If these opioid peptides breach the intestinal barrier, typically linked to permeability and constrained biosynthesis of dipeptidyl peptidase-4 (DPP4), they can attach to opioid receptors. The widespread presence of opioid receptors spanning gut, brain, and internal organs is fundamental to the diverse and systemic effects of food-derived opioids, with effects being evidential across many health conditions. However, manifestation delays following low-intensity long-term exposure create major challenges for clinical trials. Accordingly, it has been easiest to demonstrate causal relationships in digestion-based research where some impacts occur rapidly. Within this environment, the role of the microbiome is evidential but challenging to further elucidate, with microbiome effects ranging across gut-condition indicators and modulators, and potentially as systemic causal factors. Elucidation requires a systemic framework that acknowledges that public-health effects of food-derived opioids are complex with varying genetic susceptibility and confounding factors, together with system-wide interactions and feedbacks. The specific role of the microbiome within this puzzle remains a medical frontier. The easiest albeit challenging nutritional strategy to modify risk is reduced intake of foods containing embedded opioids. In future, constituent modification within specific foods to reduce embedded opioids may become feasible."[emphases added]

So effects, if any, uncertain and not limited to dairy.

gomelgo profile image
gomelgo in reply topark_bear

Let me understand this. And I mean no disrespect at all. But in the spirit of the questions necessary to science ... You looked for the answer to whether dairy contains morphine, and you found this one study that says that research is inconclusive about whether it is detrimental? And that lead you to state "So effects, if any, uncertain and not limited to dairy."? I'm just wondering if there isn't some level of confirmation bias possible here.

I was not making a statement about detriment, though it is implied since opioids don't seem to do anyone any good in the long run. I was very simply stating that dairy products contain it. I tend to let people make their own decisions about how their bodies react to various items.

GermanShepherd79 profile image
GermanShepherd79 in reply topark_bear

I agree with your conclusion. I like cheese because it is salty. I crave salty but avoid chips chips and junk. I doubt I eat cheese once a month but I like it. Not addicted. Not sure baby animals become addicted. But I wonder how this compound ended up in there. Hmm. Has the EU banned it, they are more progressive than the US when it comes to food. I think I’ll look into it too. Just curious.

Missy0202 profile image
Missy0202

I take magnesium citrate and vitamin C at night. I also spend a few moments in bed rubbing sesame oil on my abdomen in circular motions. Great post PB!

Lizzy9 profile image
Lizzy9

Thank you for starting this post, park_bear. Good information for future!!! (Hopefully it won’t be needed!). HwP drinks a glass of kombucha with a tablespoon of homemade Fire Cider in it and a small serving of fermented cabbage at breakfast and chopped salad at every meal daily. Seems to keep him regular. If we leave one item out he has problems.

He is newly diagnosed, so I don’t know if things will change over time.

Lotsopasta profile image
Lotsopasta

For me, I get out of bed in the morning and do not sit down. I stand, do light housework, read, but no sitting. This let's gravity do it's thing. Doesn't always work but helps. I recently added a pat of natural grass-fed butter to my cornbread for breakfast, evaluating but might work for me.

Rhyothemis profile image
Rhyothemis

I don't know what's wrong with me but I have had really bad constipation for a few years (and insomnia and sometimes urinary incontinence - just like my dad did early on with his MSA, which isn't supposed to be hereditary). I tried a lot of things to fix it including a very high fiber diet and lots of resistant starch; I track my food intake with an app called cronometer so I know how fiber much I'm getting.

Anyway - the one thing that has helped me most with constipation is teff porridge - 200-300 grams/day. I get the organic stuff from Whole Foods when available. Amazing relief. I also take miralax every night before bed, but by itself the miralax does not do much at all. I take it now mostly to make things easier on the way out, if you know what I mean.

Another thing that will work is 2 bottles of Yakult. I usually just do one bottle each evening. It seems to help with sleep and anxiety, also.

Broccoli sprout smoothies help a bit, mostly I find they help with GERD. There is at least one study on broccoli sprouts for gut motility in IBS.

BruceDavies profile image
BruceDavies

I have tried it all; thiamin, magnesium citrate, vitamin c, fiber, stool softener, miralax, lots of water, and still have problems. However I haven't given up. I just started restricted starch. One study says it helps constipation. I am starting to think part of my problem may be a side effect of ropinarole. In this case none of these solutions will work. Why is the squalamine derivative taking so long to move to a stage 3 trial?

Divii profile image
Divii in reply toBruceDavies

how’re you now?

BruceDavies profile image
BruceDavies in reply toDivii

I rely primarily on enemas.

Divii profile image
Divii in reply toBruceDavies

How much ropinorole are you taking?

BruceDavies profile image
BruceDavies in reply toDivii

2 mg (one pill) 3 times a day

faridaro profile image
faridaro

Taking at night 1/2-1 teaspoon Triphala powder (see note) along with several soaked prunes worked very well for me. Lately I substituted prunes with a fresh apple (using core, seeds and skin which supposedly contain most probiotics) and so far it's been working well too. If this remedy would fail, my next choice would be magnesium citrate which I used occasionally in the past with good results.

Note: compounds found in Triphala are metabolized by liver enzymes known as cytochrome P450 (CYP450). Taking Triphala with other drugs that utilize CYP450 may adversely increase or decrease their concentration in the blood.

cerstadd profile image
cerstadd

It might sound simple but I take two vita fusion fiber well gummies each day and it works very well!

Smittybear7 profile image
Smittybear7

Is the stool softener over the counter?

park_bear profile image
park_bear in reply toSmittybear7

Yes.

gl2238 profile image
gl2238

I have read the reply’s and for the most part the recommendations for foods that address constipation are A-OK for the individuals that do not have the complications of Gastroparesis. The diets for constipation and Gastroparesis are contradicting. One of the big differences is low fiber for Gastroparesis and high fiber for just constipation. I am one of many PWPs that have both. Forget dairy products, and specifically for PWPS with Gastroparesis, no nuts, seeds and a host of many other foods that are most adequately described for the disease on line. I take a packet of Miralax in 8oz of water in the PM and also limit anything after 4:00PM to just liquid. Sometimes even that is not enough so on those occasions, when needed, I take Bisacodyl (stimulant) 5mg each AM) for a couple of days which does the trick. Like it has been said, we are all different in our requirements to have as best of Quality of Life as is possible. Biggest problem I have found is that the Neurologists I have seen in my local area have absolutely no idea of treating the NON MOTOR symptoms of which I have many. A complication I have, Global Neuropathy, is barely controlled with 600 mg of Lyrica. I would like to hear from PWPs that have complicated GI issues requiring contraindicated foods/supplements and RX

MissRita profile image
MissRita in reply togl2238

yes I have constipation Gastroparesis…sucks! Only because I never know what to eat. There’s a lot of contradicting information out there.

park_bear profile image
park_bear

From a comment by MissRita elsewhere:

I have a recipe that works far better and it’s natural!

1 lb pitted prunes

4 ozs senna tea leaves (at health foods store)

1 lb raisins

1 lb figs

1 cup lemon juice

1. Prepare tea; use about 2 1/2 cups boiled water, add to tea leaves and steep for 5 minutes.

2. Strain tea and remove tea leaves.

3. Place 2 cups of tea, or amount left, in large pot.

4. Add all of the fruit to the tea.

5. Boil fruit and tea for 15 - 20 minutes, until soft.

6. Remove from heat and add lemon juice. Allow to cool.

7. Use hand mixer/blender or food processor to turn fruit and tea mix into a paste.

8. Place in glass jars or Tupperware and place in freezer (paste will not freeze but will keep forever in freezer also very long in fridge).

DOSAGE: 1 - 2 Tablespoons per day

Suggestions for use: Can be spread on toast, english muffin, bagel, bran muffin or rice cake. Good breakfast. lunch, or snack: toasted bagel or english muffin, spread with low fat cream cheese or goat cheese and topped with fruit paste. For a change of flavor mix in some raspberry or strawberry jam. The first time I made this, I cut the recipe in half, used the full recipe after that. The stuff seems to work just fine, as long as you use it regularly .... it's all natural, no chemicals, no preservatives, just a little bit of money and time invested.

Juliegrace profile image
Juliegrace in reply topark_bear

My doctor advised against using senna regularly. She said it is something that should only be used occasionally.

park_bear profile image
park_bear in reply toJuliegrace

She may be right but I did not find support for that in the literature:

Efficacy and safety of laxatives for chronic constipation in long-term care settings: A systematic review

onlinelibrary.wiley.com/doi/full/10.1111/jcpt.12721

" Studies including senna

Senna was the most studied intervention in the included RCTs, either as the main intervention or as the comparator. These trials were of different quality levels according to Jadad scale. Two of the RCTs were of high quality (Jadad score 4-5), whereas one RCT scored as low as 1. The efficacy and safety of senna was tested against lactulose, SPS or placebo. These trials concluded that senna was equally as effective as SPS [sodium picosulphate] or more effective than lactulose or placebo. The longest duration of treatment with senna was 5 weeks."

I do not use it personally.

gaga1958 profile image
gaga1958 in reply toJuliegrace

my dr also said the same thing. apparently, the body gets dependent on it.

kaypeeoh profile image
kaypeeoh

Why is "Natural" better then "Medical" remedies? Is it cost? Pure water is a poison if you drink too much of it.

park_bear profile image
park_bear in reply tokaypeeoh

I am not against using medical substances - I have welcomed all comments here. That included placing a like on your comment recommending dulcolax.

I posted what is working for me. Personally I prefer my solution of thiamine, vitamin C, and MCT Oil because these have additional benefits.

gomelgo profile image
gomelgo in reply tokaypeeoh

Personally, I would prefer food sourced remedies to chemically derived and/or synthetic ones because I believe we are a part of nature.

“What works for you?”Magnesium Citrate capsules, 3 capsules a day, Three days out of twenty-one missed bowel movement.

kaypeeoh profile image
kaypeeoh

10 months later the dulcolax doesn't work so well. I opened my big mouth at the exam yesterday so I've been referred to a gastric specialist.

Boscoejean profile image
Boscoejean

For my husband with Parkinsons what seems to have helped was getting treated for SIBO and taking magnesium citrate, drinking 2 or 3 more cups of liquid per day, vitamin C and he does take B1. The SIBO treatment initially involved two different antibiotics and the GI doctor had him take Align. He has quit taking Align now. He does take probiotics but it is my understanding that some probiotics can be problematic for a person with Parkinsons. The three probiotics he takes are lactobacillus rhamnosus GC, plantarum PS128, subtilis pxn21 but the constipation had pretty much resolved prior to starting these. I wish I could find the article about microbiome tests showing an accumulation of some probiotics in Parkinson's patients who took probiotic combinations that were considered problematic.

rebtar profile image
rebtar in reply toBoscoejean

If you find that please post it. It would be useful.

Nanismami profile image
Nanismami

Moved to NY right before covid lockdown. Got Covid, then a tick bite…didn’t know anything about Lyme. Then became severely constipated. My theory is due to covid lockdown lowering my activity level, moving to extremely humid NY, drinking a little bit more alcohol, and ending up with impaction changed my gut microbiota from healthy to severely unhealthy (had blood and stool tests, paid for by me, which confirmed.) Bowel habits changed from daily to 3-4 days between. And difficult to accomplish to boot.

I did NOT have symptoms of Parkinsons before all this. Some months after impaction began (finally confirmed by MRI, paid for by me, due to pain under left rib cage) began severe tremors, drooling, difficulty walking, lack of expression, really bad balance, stooping, memory difficulties, trouble sleeping, etc.

Started taking probiotics, really high doses and various brands and types. Started drinking purified water, not from a bottle, no tap water due to blood test showing high mycotoxins and a moldy smell coming form faucet. Have started eating a lot of fermented vegetables, olive oil, and avocados. AND taking UN-enriched nutritional yeast along with B vitamin supplements. Some of the B’s help you. Ascorbic acid (vitamin C) and magnesium in various forms help. I also used a thumping type massager.

If you have MTHFR gene mutation, you need to be careful about the type of folate you consume and should avoid enriched flour like the plague.

This is a really important point if you do B1: B vitamins are water soluble. You sweat and they deplete. You stress and they deplete. If you take one in really high doses, apparently it will cause other B vitamins to become deficient!

(Please see the pictures from a nutrition book I read 40 years ago, “Know Your Nutrition.” This book helped me get rid of bronchitis completely after suffering for 20 years and several emergency room visits and hospital stays. 30 years bronchitis free and Covid didn’t hospitalize me.)

Lately I started taking Chinese traditional medicine herbs that have been clinically researched as they work on specific cell activity of the nervous system. I’m able to poop daily now. Neurological symptoms are much milder and improving. I can jog now. I don’t walk like a drunk anymore. I also started treating undiagnosed Lyme with rifing and herbs.

B-1 important information
beatles4ever profile image
beatles4ever in reply toNanismami

What is the name of the Chinese herbs & where do you purchase?

Miranda24 profile image
Miranda24

restorolax over the counter.every other day PEG for short neurologist recommended. Some how uses water

MissRita profile image
MissRita

what brand of MCT oil do you use? Also, how much do you take a day?

park_bear profile image
park_bear in reply toMissRita

azurestandard.com/shop/prod...

I take about a tablespoonful or two daily poured over appropriate foods.

gaga1958 profile image
gaga1958 in reply toMissRita

try MCT brain C8, brain octane from BulletProof.com. bcuz it does have an effect, start small and build up. try 1 tsp first then 2 tsp etc. 2 tbl/day if good for the brain also.

gomelgo profile image
gomelgo in reply togaga1958

I saw a label on my cbd oil that called it "mct oil". Anyone know anything about this?

PDWarrior1900 profile image
PDWarrior1900

wow thanks pal!

Smittybear7 profile image
Smittybear7

Thanks I'm taking 500 b1 and am constipated. Should I add 500 once a week to see if that helps? I am afraid that additional 500 a day will be too much. I have a n appointment with a new movement specialist in three weeks. I don't want to be evaluated if I am experiencing side effects. Your thoughts!

park_bear profile image
park_bear in reply toSmittybear7

If you've already established your correct thiamine dosage I would leave that alone and add vitamin C and or MCT oil.

gaga1958 profile image
gaga1958 in reply toSmittybear7

for constipation try adding magnesium citrate, I use 2@500mg at night

Williemom profile image
Williemom

thank you for all helpful info. I appreciate all comments. Maybe I will try increasing his magnesium at night and or miralax in a.m. and p.m. to see what that does before adding any more pills, et. He hates all the pills and vitamins he already takes but think necessary. Could be the Ropriniole?

park_bear profile image
park_bear in reply toWilliemom

I understand regarding the pills. I add the vitamin C to my drink, and add MCT oil to food as appropriate. Constipation not a side effect of ropinirole as far as I know.

Williemom profile image
Williemom

thank you for the good info. So many replies, not sure which one to try at first. Said below I might try the increase of magnesium and miralax before trying other remedies. If that doesn’t help then we will try something else.

Thanks again. Everyone on this site are so kind and so willing to help each other. God bless.

Williemom profile image
Williemom

👍🏼😃

Thaxter profile image
Thaxter

I buy a product called MagO. It's pricey, but worth it. Three capsules every night, and I usually have a BM next morning. Staying hydrated is key but I don't always do it.

Alock2020 profile image
Alock2020

5 to 10 grams of Vitamin C daily sounds like a lot to me. I've seen a number of articles that state that 2,000 mg (2 grams) is the most that an adult can safely take.

park_bear profile image
park_bear in reply toAlock2020

Link please.

If you do not care for vitamin C you can use more MCT oil, magnesium, or docusate sodium.

Alock2020 profile image
Alock2020 in reply topark_bear

Here's one: mayoclinic.org/healthy-life...

park_bear profile image
park_bear in reply toAlock2020

" Although too much dietary vitamin C is unlikely to be harmful, large doses of vitamin C supplements might cause:

Diarrhea

Nausea

Vomiting

Heartburn

Stomach (abdominal) cramps

Headache"

Emphasis added. This is not the kind of harm that goes on undetected and thereby causes long-term damage. If any of these occur the solution is simple - back off on your vitamin C intake.

Wind_in_the_trees profile image
Wind_in_the_trees in reply topark_bear

High dose vitamin C supplements should be avoided, particularly if an individual has a history of calcium oxalate stones

health.harvard.edu/blog/hig...

Vitamin C in supplemental form, given at a high dose, can cause diarrhea (or reduce constipation) in part or maybe because it is digestively disruptive due to increasing oxalates.

fixyourgut.com/vitaminc/

Armyman profile image
Armyman

I take 2 heaping teaspoons of a magnesium supplement called Calm made by Natural Vitality. I also drink a minimum of 2 liters of water daily. This works quite well.

BH68 profile image
BH68

Dried figs, chia seeds, coffee, walking and work-stress do it for me. Also, cask-conditioned ale. Some of these are more appealing than others…

bassofspades profile image
bassofspades

A thousand or so mg vitamin c with rose hips can help, I am finding!

Lyrics19 profile image
Lyrics19

I take 1 dulcalax laxative every other night and drink lots of water. It seems to work pretty well for my constipation

kaypeeoh profile image
kaypeeoh

I add one cap-ful of miralax powder to coffee.

Greensnail profile image
Greensnail in reply tokaypeeoh

Note the 5/18/24 update about polyethylene glycol at the end of PB's post above. .According to Miralax website the active ingredient is Polyethylene Glycol 3350 livewell.bayer.com/sites/g/...

Bunny622023 profile image
Bunny622023

It's a great post this as it's such a big problem for many pwp's. And as it shows above, so many people get benefit from totally different remedies. Senna loose leaf is absolutely a great product for my husband and other pwp's we know. We don't see a reason for it to be stopped when the Neuro also says it's totally fine in the doses we use and it works.

My husband has had senna (loose leaf tea only) with fruit tea for the past 15 years to help with constipation from the PD. It has been effective and had no side effects that we know. He eats prunes and fruit religiously every day, drinks a ton of water, and takes 1 Colace (non laxative) stool softener at night. This keeps him very regular every 2nd to 3rd day. He's a careful eater but nothing else works. I am going to get him to try at some point the Cucumber smoothie someone mentioned, but Senna (pure loose leaf) tea has been the only thing to keep him even. I know it doesn't work for everyone, just like prunes and kiwi and every other fruit doesn't seem to help him alone.. .it all just probably helps together. Luckily he has never been impacted. Colace on it's own does not help. Nulax is another product he tried year ago which is Figs & senna mixture... quite an unusual texture, but we found the tea is far better and easier. :-) Thanks for your list, that's great for everyone.

Pixelpixie profile image
Pixelpixie

I make a blender beverage for bkfst and add 1T Chia and Flaxseed in addition to other ingredients. Never have a. problem

M-o-ggy profile image
M-o-ggy

Thank you for this very informative post although it isn't the one that I read. As I remember the post I read started with comments on how different people manage their PD lives and at one stage recommended using tissue salts.

At the moment I take Vit C, peppermint oil, coconut oil, B1, Magnesium Citrate, a Probiotic recommended on this site and which I find very helpful, use a heat pad and stomach massage, have reminders on my phone to drink water. When this doesn't work I add 2 sachet of stuff from the Dr,which does help although I don't like doing so as it tastes very chemically .

When I am home all day I cope much better. If I am out and about it takes at least two days afterwards to have any BM.

A friend has a surfeit of pears and I have added two pears a day which has helped. My local store had beetroot for sale so I bought some and I have added one large boiled beetroot a day to the list and this last two days have worked wonderfully.

Jussi212 profile image
Jussi212

Thank you for this thread. FYI, 3 months ago my PWP started using enemas 3-5 times a week and it seems to make a difference. Defecation happens more often and does not usually require a stimulant. Before this, many years were quite problematic and many tricks were tried but found not helpful.

The enema device is a simple bulbous rubber thing, holding about 1,5 dl water. Plus a flexible tube and a replaceable tip at the end.

Frequent use of enemas was the change that brought significant relief.

Other aids include osmotic laxative: 12 g macrogol 4000 dissolved in water twice daily, oatmeal porridge in the morning, and lots of olive oil with every food (add it to porridge, rice, veggies, everywhere). In general, Mediterranean style eating. No fiber supplements, special herbs or anti constipation medicines.

bullet65 profile image
bullet65

Restoralax works for me. It was recommended by my doctor.

Greensnail profile image
Greensnail in reply tobullet65

Note the 5/18/24 update about polyethylene glycol at the end of PB's post above. According to the Restoralax website the active ingredient is Polyethylene Glycol 3350: restoralax.ca/en/products/r...

park_bear profile image
park_bear in reply toGreensnail

Thanks for realizing that these are versions of polyethylene glycol!

reedboat2 profile image
reedboat2

I’m using 2 TCM products prescribed by my acupuncturist. The first increases motility in the upper GI: Six Gentlemen Teapills. The second targets motility in the lower GI: Cynomorium Songaricum Extract. Note that Cynomorium is used in TCM for a number of purposes, including increasing testosterone levels, particularly in Korean formulations. The daily use of these two seems to help in my case. Hope this helps- JG

Kat343 profile image
Kat343

HI, I wanted to add a bit here as my HWP has used Triphalia before and I looked it up the due interactions - and its still a bit confusing, but thought I would share the article that I could understand best... verywellhealth.com/triphala....

Next, we started with a naturopath a few weeks ago and she suggested taking this very specific brand and type of mag citrate (H2Go) - it works great for him, me and my mom! And it has never resulted in diarrhea. Initially we purchased it on Amazon, but If you go directly to Lane Innovative, you can basically get 3 bottles for the price of 2 with a subscription and we will continue using this as she says there no long term side effects. Read all the info on the page to see if it may be helpful.

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