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Wednesday, November 14, 2018

PD Constipation Octopus

SHERRYL KLINGELHOFER·        TUESDAY, NOVEMBER 13, 2018






This octopus represents the management of constipation. Each tentacle represents either a PD constipation cause or a pro-active way to deal with it. The legs act and react together, twist and entwine…affect one and you essentially affect all.

Being constipated can be more than just a nuisance.It may interfere with how well your medications are absorbed, making them less effective.  I heard  a two-doctor presentation saying that IF YOUR MEDICATIONS BEGIN NOT WORKING AS WELL,  CHECK TO SEE: ARE YOU CONSTIPATED? DO YOU HAVE AN INFECTION? (usually urinary, which can be caused by constipation)

Being constipated can make you feel unwell, uncomfortable, irritable, nauseated or lethargic. It can cause psychological and social distress, consequently reducing quality of life.Wow. That’s some of PD’s non-motor symptoms already.  Add to thesetoxin re-absorption in the colon, imbalance of intestinal flora(causing overgrowths of unwanted bacteria or pathogens) and structural and physical effects from large hard stools and straining to pass them.

75 percent of people with Parkinson’s are very inactive…and 50-65 percent of PwP suffer from constipation!

Exerciseis a key element of constipation management. Abdominal muscle movement helps to activate the digestive system.  Steady, moderately strenuous exercise, such as gentle walking, swimming or light weightlifting, is one of the best ways to accomplish this. Walking regularly and trunk twisting (as doing regular or chair yoga or Tai Chi) were not just suggested, butstressedby care partners at the World Parkinson Congress 2016.

Fiberhelps drive waste through the intestine. Gradually increasing the amount of fiber in your diet can be helpful for constipation. Vegetables, berries, fruits with skin (e.g., pears, apples) and whole grains are good sources. Eating smaller meals throughout the day ( instead of fewer larger meals), helps with constipation as it allows more time for digestion.

Fiber needs lots of waterto work!  Water increases flow through the digestive tract, allowing the system to function more effectively. Higher amounts may be necessary for some people, especially in hot weather, but start with at least six-8 ounce glasses and build to eight per day. Drinking warm liquid in the morning can sometimes stimulate a bowel movement.

Do not take any high fiber laxatives or eat high fiber food if constipation has been going on for several days. Instead drink liquids (preferably warm/hot) to give water to what is already in the system. If you add more fiber to blockage, you just have more blockage.

Although a daily bowel movement is not necessary for health…but if blockage is not addressed after five days, you should contact your doctor/ER immediately. That said, IF the above suggestions don’t work here are some ideas for you---they need to be used with adequate water intake to work well.

· Stool softeners, such as docusate (Colace) can be used if stools are very hard. These can be taken short-term on a daily basis and should be used in conjunction with dietary modifications and exercise.

· Laxatives work in different ways. Some, such as polyethylene glycol (Miralax), pull water into the colon to ease constipation. These are fairly gentle and very popular. "Stimulant" laxatives, such as bisacodyl (Dulcolax) or senna (Senokot), promote muscle contractions in the digestive tract. As a general rule, these aren't recommended for daily use as they can be more harsh and associated with dependency.

· Enemas are sometimes used for significant constipation, but these should be used cautiously and under the advice of your health care provider. 

Although there are no prescription drugs specifically for Parkinson's-related constipation, the U.S. Food and Drug Administration (FDA) has relatively recently approved three drugs for "chronic idiopathic constipation" -- constipation not due to a known medical cause or medication. These drugs -- linaclotide (Linzess), lubiprostone (Amitiza) and plecanatide (Trulance) -- may be considered in certain cases after diet changes, exercise and the above over-the-counter therapies have failed. However, they can be expensive.

As with all Parkinson's symptoms, you should discuss the treatment of constipation with your personal physician so you can work together to find a regimen that fits your needs.

Lots of folks like my PD constipation management octopus!


...but so many people seem to be using the "last resort" tentacle a lot more than the "water" and the IMPORTANT "exercise" legs! Since the body was meant to move, not sit, processing food will be easier when you are active!


Remember to use those two before the last resort!I found many great videos for constipation exercises, BUT they aren't appropriate for many with PD...too physically challenging, usually on the floor. But here is a video the can help you really "get down to business" 



Here are links to the sources used in this Note:






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