February 20, 2020 at 9:28 pm #17982Robert HarrisParticipant
Constipation seems to be a very common problem for Parkies, apparently due to the lack of proper bowel muscle operation (dopamine affects every muscle) and/or due to a side effect of one or more medicines.
So, what can you do to remedy this chronic condition? The solution has to be long term and not harmful, so a regular double dose of those extreme blow-out laxative products isn’t a good answer. Here is what I have done and/or am doing now. Be sure to consult your neurologist before implementing any of these regimens. From mildest to most dramatic, they are
1. Drink more water and juice and fluids. Parkies are known for being slightl dehydrated, and water is needed to process the former food.
2. Eat more fiber and drink high-fiberf juice. Prunes and prune juice are obvious choices, but apples, bananas, avocados, peanuts and other natural foods are great sources. Eat fiber bars. Some of them have up to 9 grams of fiber per bar. Be warned, however, many of the bars are spiked with chicory root, which tends to cause bloating and gas. Eat one of those bars for breakfast and you might clear out your whole office before noon. Wheat bran is also recommended by food folks, and psyllium is too. I like prunes (which have now been rehabilitated by calling them “dried plums”) and peanuts and avocados, and apples. Don’t overdo it, though. Too much fiber can cause–wait for it–constipation. The recommended amounts of fiber that I see on reputable web sites is 38 grams per day for men under 50, 30 grams per day for men over 50. For women under 50, 25 grams per day; for women over 50, 21 grams per day.
2. Take 1 to 2 stool softener pills per day. The stool softener is docusate sodium and comes in 100 mg gel caps. The directions on most bottles say you can take up to 3 pills (300 mg total) per day. I take one pill per day, at my 6 am medicine feast.
3. Magnesium is also recommended for Parkies with constipation, because it also helps treat magnesium deficiency, which can cause restless legs and fidgeting. There are several forms available: Magnesium gluconate, and magnesium citrate can supply a laxative effect. Recommended dose per day is 400 mg.
4. The Nuclear Option: Consult your neurologist of doctor before resorting to the nuclear option. Here’s what I’ve learned from experience. (I guess having Parkinson’s means never having to say you’re embarrassed.) I buy those 4.5 ounce saline enema bottles from the dollar store or anywhere, and POUR OUT THE CONTENTS. Then I fill the little bottle with warm tap water, put some hand soap on the nozzle to lube it, and go for it. In about five minutes I usually have the desired results. On rare occasions, when one bottle is insufficient, I refill the bottle and bomb my bum twice. Beware, with the second load of water, results are almost always immediate. I have used this treatment for at least a year and have had no untoward effects. And I’m not injecting drugs, only tap water. When my constipation has driven me to feel sad, bloated, out of sorts, sluggish, lazy, and tired, I pursue the nuclear option and half an hour later I feel rejuvenated (as much as a Parky can feel rejuvenated).
February 25, 2020 at 1:28 pm #18010Jo S.Participant
The only thing that has worked for me fairly consistently is taking Miralax every day (with my doc’s approval). From what I’ve read, this is a common solution for PWP (and a good way to avoid the nuclear option). 🙂 I also take magnesium citrate before bed and also try to drink plenty of water and clear fluids during the day. It’s not perfect, but this combo has worked better for me than others I’ve tried. Prune juice, fiber-rich foods, fiber supplements, etc. have been both inconsistent and unreliable.
February 25, 2020 at 2:50 pm #18018Toni ShapiroParticipant
Thank you for this topic. I also have a big problem with constipation. I always drink extra water, eat lots of fiber, take magnesium 150 high absorption 2 times a day, senokot stool softner, restoraLax (suggested by my neuro) and glycerine suppositories when necessary. However, I can and I do have bowel movements with this regime. The issue I have is that I spend a great amount of time in the bathroom whether I go or don’t go. Strain or don’t strain. I spend an amazing amount of time in the bathroom either way. I find I wake up between 3-5 am most every morning because of bowel pressure. My average time in the bathroom is 45 minutes but at times I wait over an hour. The rest of my day is similar. I’m sorry to be so graphic but I havn’t read anything very specific on this topic. Most of us just say constipated but like all of PD symptoms each of us can experience something odd or different. I don’t know if anyone can relate to what I mean and if others have this kind of bowel issue. My massage therapist has suggested stomach massage that she says can be very helpful. I will be trying it soon and will come back to this post if I find it helpful.
March 2, 2020 at 8:13 am #18126Gail DonsParticipant
My personal record in the constipation department was 2 weeks with no action. Miralax, Dulcolax tablets, Magnesium Citrate…nothing worked. I eat plenty of fiber. I exercise. I thought I was getting adequate fluids because my urine was usually very pale/clear. Then one day I realized that a large proportion of fluid intake was caffeinated. Caffeine can pull the water from your gut and put it into your urine instead. Voila! That makes nice dilute urine and stools like cement! I got a “Water” app on my phone and started tracking my water intake. Not as impressive as I’d thought. I set my target for 72oz per day and within 2 weeks my bowel function improved markedly. My MDS told me she wanted me to have 3 movements a week, and now most weeks I am there! I know this is not the perfect solution for everyone, because PD slows down the movement of your gut itself. However, for many PwPs that are new to this game, actually tracking your water intake and improving it may surprise you.
March 4, 2020 at 10:15 am #18160James HarveyParticipant
For about 3 months I had mild, intermittent abdominal pain and no appetite for an evening meal. Eventually the abdominal pain increased to the point that I went to an ED and, after an abdominal CT, was diagnosed with constipation. I had been taking oxybutynin (oxy) to calm my urinary bladder to decrease nocturia and apparently the oxy was contributing to constipation by reducing bowel peristalsis. I stopped the oxy and started taking 1.5 doses of Miralax and three 500 mg Citrucel tablets each day. (I use the generic versions of each.) I keep a BM diary to track the approximate amount of stool that I am passing each day. (Usually I just estimate, but I do have a strainer and scale that I use occasionally to check my estimates.) If I pass less than 10 oz of stool per day for 3 days (or if I have symptoms like abdominal pain or loss of appetite) then I take one extra dose of Miralax, one extra Citrucel tablet and 17 mg of sennakot before bed for one or two days. I have been using this regimen for about 9 months. Seems to work for me.
March 4, 2020 at 10:16 am #18161RoyParticipant
My hubby has also suffered with constipation issues. He has finally found a regiment that works for him, so I’ll share it in hopes it helps others. First, water is of utmost importance. We live in Florida, so staying hydrated is a must. Adding in the constipation issue just adds to the mix. Next, a piece of fruit with each meal, at least, per day. Add a cup of Smooth Move tea each evening. Two 30 minute walks each day, for more reasons than just the constipation. A half cup of unsalted, mixed nuts each day. A Docusate (stool softener) each day, as prescribed by his neurologist. It took a couple years to find the right amount of food/meds to make for regular, fairly quick, and painless bowel movements. Previous to that, it took up to a whole 24 hour day to pass “the plug” that then allowed enormous amounts of stool to follow. We hope that this may help someone that is still struggling with constipation.
March 4, 2020 at 5:57 pm #18171
I didn’t realize that constipation could be linked to PD. Thank you for sharing your experiences. Do you think that hydration is the best strategy?
March 4, 2020 at 8:20 pm #18175RobertParticipant
I admit to daily Miralax. Otherwise, don’t want to talk about it!!
March 4, 2020 at 10:51 pm #18177RobertParticipant
Or hemorrhoids!! Don’t want to talk about that either!!
Why can’t they just send us the pamphlet with the not so nice things about PD, and, while they are at it, about this getting older thing too, and just get it over with!!
Oh, and the easy solutions to all of them too, of course.
March 5, 2020 at 1:59 pm #18181Jo S.Participant
Hi, Mary Beth. Constipation is often one of the first symptoms that people with PD have. https://parkinsonsnewstoday.com/2018/02/08/10-early-signs-of-parkinsons-disease/
March 9, 2020 at 10:05 am #18212
Thanks for the reference, Jo. My Dad also has ulcerative colitis and he lost his colon many years ago. So, I know that his digestive process is difficult but it doesn’t quite function the same way as it used to.
March 10, 2020 at 11:26 pm #18238Gail DonsParticipant
Hydration is a great place to start, because it has to be a part of ANY constipation treatment regime. Traditionally, good bowel function is made up of fiber, fluids and exercise. It’s sort of like a three-legged stool: do without one of these and the whole thing falls over. For some PwPs, having a properly balanced 3-legged stool is all it takes. For others, various other things must be added – and the right routine is as varied as each individual PwP. But first start with the easy stuff. Water is cheap. Exercise is good for many aspects of PD. Fiber can be deliciously added to a diet plan. Cheap, easy, doesn’t interfere with any of the meds. Add more ruffles if the basics alone don’t do the trick.
March 11, 2020 at 8:12 pm #18252
Thanks for the tips, Gail! It sounds like you’ve done your research.
March 13, 2020 at 4:18 pm #18277Yekim7676Participant
Why not keep the saline?
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