Thursday, January 2, 2020

C is for Constipation


I am “borrowing” Sherri Woodbridge’s creative approach to sharing PD information.  I don’t know what her “C” was, but this will be information that I hope will be useful based on my experience.  

This is not the most pleasant topic to write about.  However, after ten years with PD I know that it is one of the most important!  I learned early on that constipation was on the list of non-motor symptoms.  I don’t know what the stats show, but I have never met anyone who has had PD for a few years or more that doesn’t have this problem.

I am not a doctor, but I understand that PD constipation is caused by changes in the intestinal muscles that humans rely on for bowel movements.  I think I started to notice this problem at around 3-5 years and it has progressed gradually.

Some years ago, Dr. Michael Okun shared with me that there a few things that play a major role in the quality of PwPs daily lives.  Quality of sleep was one (no surprise).  I think hydration was another (it can affect many things, including headaches, blood pressure, dizziness, “regularity”, and more).  The third was the “C” word.

According to Dr. Janis Myasaki, PD palliative care pioneer who recently did an online PD palliative care “expert briefing” for the Parkinson Foundation, the goal for PwPs should be to have at least one bowel movement EVERY DAY.  This has been my own personal strategy for about the last five years at least.  If that didn’t happen, I would start feeling “lousy” (due to bloating, indigestion, headaches, and lack of energy).

Reverting to strategic planning terminology, the tactics I used to stay “regular” have evolved over time.  Different people use different tactics.  Whatever works is good, but be sure to discuss this with your movement disorder neurologist.  I started using Puritan Pride Herbal Laxative (I am not promoting this product, but it is what worked for me).  My doctor told me I didn’t need to worry about “overusing” this type of product.  Just stay hydrated, get exercise (beneficial on many levels), and use enough for it to work.  I would suggest experimenting with the number of capsules (taken at bedtime for results the following day).  If Plan A as described isn’t effective, I use glycerin suppositories and, as a last resort, Fleet enema bottles (available at most drug stores or in the pharmacy department of your grocery store, WalMart, or Target).

Abdominal bloating has become an ongoing problem for at least the last three years.  I have tried all kinds of “Gas X”-type products with no noticeable success.  I made an appointment with the gastroenterologist that does my colonoscopies to discuss this issue.  He prescribed Linzess to achieve regularity (supplemented if necessary by a minimal amount of herbal laxative) and to try to reduce the bloating.  I can report that, while this hasn’t helped with bloating, it has achieved dependable regularity.  I have found that the nature of the movements (we are now moving from mildly distasteful to totally disgusting information) has varied from solid to squishy to pellets to mostly water (this isn’t diarrhea so medication for that not required).  Also, be forewarned that movements can be “ballistic” occasionally so have a toilet brush available (helmet optional).  Might as well have a little fun with this. 

As I said, this has been my experience and what works for me.  Don’t be reluctant to discuss subjects like this with your doctor! 

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