How To Deal With Constipation In Parkinsons Disease
It is estimated that over 50% of Parkinsons patients experience constipation, which is one of the key symptoms of Parkinsons disease that causes discomfort to patients daily life. Unlike other symptoms, this problem can possibly be treated without medication by making some changes in diet and other lifestyle behaviors.
Here, you will get to know 4 key ways that help you dealing with constipation in Parkinsons disease.
People with Parkinsons disease are usually complaining of frequent constipation and it is thought to be a side effect of medication. But this could also be one of the earliest symptoms of the disease.
In recent years, researchers have increasingly realized that there is a strong connection between constipation and Parkinsons disease. They think that frequent constipation is the indication of certain cells in the brain that are linked to Parkinsons. Since this problem appears many years before the onset of motor symptoms, it could be used as a useful criterion for the early diagnosis.
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What Causes Constipation In People With Parkinsons Disease
During digestion, the muscles of the intestine contract simultaneously to move the food bolus through the intestine and excrete the undigested material in the stool.
Parkinsons disease causes degeneration of the neurons that control the intestine muscles, which slows down the digestive process and stool elimination. As a result, stool stays longer in the last part of the intestine, the colon, where liquid is reabsorbed by the intestinal wall, making it dry and harder to evacuate.
Symptoms of the disease can increase constipation problems. For example, less physical activity leads to less bowel stimulation. Difficulty chewing and swallowing may reduce the tendency to adopt a fibre-based diet and to drink enough water and beverages .
Some medications can also cause a decrease in the frequency of bowel movements. Talk about this with your doctor.
Constipation is common in the general population. Lifestyle and diet changes can often solve this problem.
- Make sure you eat enough vegetables and fruit, fresh or cooked.
- Add fibre to your meals .
- Increase your water intake . If you increase your fibre intake without drinking more water, you will be even more constipated. Try to drink more often and in small amounts.
- Eat several small meals during the day.
- Avoid coffee and alcohol since they cause dehydration.
- Do physical activity 15 to 30 minutes per day to stimulate your intestine.
- Drink slightly warmed prune juice.
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How Is Constipation Treated
The treatment of constipation typically begins with optimization of fiber and fluid intake. While fiber may be increased through changes in diet, it can be challenging to get people to change their long-standing dietary habits. For many people, the addition of bulking agents such as psyllium or methylcellulose is an inexpensive and simple way to increase fiber. Polyethylene glycol, guar gum and lactulose are other choices that have less texture though may be more expensive than bulking agents. For an occasional patient stimulant laxatives or prescription medication is necessary to control symptoms of constipation.
Neil R. Greenspan, MD, FACG Gastroenterology Associates Providence, RI
How Might Homeopathy Help
Homeopaths believe homeopathy can help with any condition in which the body has the potential to self-repair. As a result, they suggest homeopathy can be used to treat a wide range of acute and chronic medical conditions.
Homeopathy is popular. However, despite extensive research, theres no good quality evidence that homeopathy is effective as a treatment for any health condition. There are no studies on homeopathy for Parkinsons.
Homeopathy isnt widely available on the NHS. In 2017, NHS England recommended that GPs and other prescribers should stop providing it. It is available privately.
Some health professionals, including doctors, nurses and pharmacists, are trained in homeopathy and use it alongside conventional medical treatment. Theyre all regulated by their relevant professional body for example, GPs are regulated by the General Medical Council.
Some homeopaths arent medically qualified. Currently, there are no national standards of training and accreditation for these practitioners. If you decide to see a homeopath who isnt medically qualified, you should check theyre insured and registered with a professional body.
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Datasets Included In The Statistical Analysis
FAS with modified intention to treat
Patients in the intervention group will receive at least one treatment and have one therapeutic evaluation following treatment. Patients in the waitlist control group will receive at least two evaluations.
Per protocol set
Patients in this data set must meet the following criteria: patients in both groups must complete the efficacy evaluation in week 12 patients in the intervention group must reach a certain level of compliance, that is, patients must complete at least 80% of the 30 EA treatment sessions .
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Diagnosis Of Constipation In Parkinsons Disease
Diagnosis of constipation may include:
- medical history
- detailed description of symptoms
- physical examination.
Medical problems other than Parkinsons disease can also cause constipation. Your doctor may wish to do tests to rule out other possible causes. The tests depend on the medical condition under investigation.
Treatment Should Be Tailored
The saying: If youve met one person with Parkinsons, youve met one person with Parkinsons reflects the fact that the condition affects people very differently. This means that treatments need to be carefully targeted to an individual. A one-size-fits-all approach to care means that people are given the same treatments regardless of their circumstance. This approach, while often applied, fails to take into account a persons experience of the disease, their unique needs and the goals they want to achieve. As a result care is often fragmented and unsatisfactory.
Being diagnosed with Parkinsons can cause understandable worry and uncertainty about the future. However, there are many effective drug treatments. Care is often supported by occupational therapists, physiotherapists and nurse specialists who can help people live fulfilling lives.
Most people with Parkinsons will be offered levodopa a drug that increases dopamine in the brain. But other drugs that help with movement problems are available, too. They are usually available in pill form or as a patch.
Until around ten years ago, treatment was often delayed until people became very disabled. Treatment is now started promptly to maintain peoples wellbeing and independence.
Science is progressing rapidly and the prompt recognition and treatment of the condition can mean that people can access an ever-increasing range of effective treatments.
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Final Conclusions/practical Algorithm For Management
Dysfunction of the upper GIT in PD, especially oropharyngeal dysphagia, are complex syndromes occurring early in disease that often remain unnoticed until severe complications, such as aspiration pneumonia, become manifest. In the lower GIT, constipation is a widespread and debilitating symptom with the potential of leading to severe bowel complications and even cognitive dysfunction.
In closing, standardized and early diagnostic approaches together with continuous and long-term treatment are necessary to help patients .
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What Can Be Done About These Unpleasant Gi Problems
Unfortunately, research studies on GI problems related to PD have been few and far between, so doctors do not have any tried and true methods to deal with them. Some of the drugs to treat GI problems in people without PD cannot be used for those with PD because these drugs negatively impact dopamine systems in the brain.
If you have PD and experience constipation, it makes sense to try to use safe and simple methods to address this issue before you add new drugs to your daily regimen. Increasing dietary fiber and drinking lots of water and other fluids is a reasonable first step in treatment. If your doctor approves it, you might also consider taking fiber supplements, such as psyllium or methylcellulose. If these simple methods dont work, your doctor might consider giving you a stool softener or a laxative.
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Our Body Is Made From Foods Water Air And Light Energy
- The key to effective primary health care and reversing Parkinsons is found in living as we would live, if we were in an ideal natural setting, where foods are fresh, alive, raw, sun-ripened, locally grown, in season, and pesticide-free. Water is clean. Air is clean. Light is full-spectrum sunlight.
- From foods, water and air our body must derive 50+ essential factors to function in a healthy way, factors our bodies cannot make from other substances. These include 20 or 21 minerals 13 vitamins 8 to 11 essential amino acids 2 essential fatty acids water air light and a source of energy .
- Processing removes essential nutrients from foods and may also destroy nutrients or change them into toxic substances. Deficiencies of essential nutrients and toxicity in foods have both been documented in processed foods .
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Final Thoughts: What Has Worked For Me
Some of the prescription medications that have helped me include: Amitiza, Linzess, Movantik, Relistor, Symproic, and Trulance. Plus I made sure to exercise, massage my stomach in a circular motion at least once a day, drink warm/hot water in the morning before eating, and use probiotics. I also tried to do things that helped make me feel more relaxed. In my experience, a combination of these things is what truly helps maintain a healthy bowel, which results in better PD symptom control by allowing medication to be maximally absorbed.
Toilet Habits And Constipation In Parkinsons Disease
Suggestions for good toilet habits include:
- Go to the toilet as soon as you feel the urge to pass a bowel motion. Hanging on can contribute to constipation.
- Use the correct posture on the toilet to help you pass a bowel motion place your elbows on your knees, bulge out your stomach, straighten your spine and put your feet on a footstool.
- Avoid holding your breath and dont strain when you are on the toilet. Allow yourself plenty of time.
- Use a warm washcloth pressed against your back passage or gently massage with one or two fingers to help to relax the muscles.
- Talk to your doctor or pharmacist about medicines to help soften your bowel motions.
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The Benefits Of Diet For Parkinsons
With 50,000 people being diagnosed with Parkinsons disease every year in the US, thousands of individuals are just beginning to learn what to expect, what things to avoid, and what types of food to eat to manage Parkinsons.
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Bladder And Bowel Problems
Bladder and bowel problems are common in men and women of all ages, but people with Parkinsons are more likely to have these problems than people who dont have the condition.
If you have Parkinson’s, you may be more likely to have problems with your bladder or bowels than people of a similar age without the condition.
Some of these problems are common in men and women of all ages, whether they have Parkinson’s or not.
Bowel problems are very common in the general public. But any change in bowel habit, particularly if you see blood in your bowel motions, should be reported to your GP.
Whatever the reason for your bladder and bowel problems, you can usually do something to help. It may be that the problem can be cured completely. But if that isnt possible, there are many different ways of managing the symptoms so they dont rule your life.
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What Examinations May I Need To Have
Your GP or specialist will probably ask a series of questions to find out what the problem is. These may include:
- When did the trouble start?
- How often does it happen?
- Can you feel when your bladder or bowel is full?
- Are you having difficulty emptying your bladder or bowel?
- How often are you using the toilet?
Parkinson’s symptoms, such as slowness of movement and rigid muscles, affect the muscles in the bowel wall. This can make it harder to push stools out of the body. You may be asked to keep a chart for several days of how often you use the toilet and how much you drink.
You may also be asked for a urine sample to test for infection and they will normally carry out a physical examination.
Bladder or bowel problems can be complex in Parkinson’s, so sometimes specialist tests or X-rays may be needed. All of these can usually be done in an outpatient department or clinic.
Constipation In The General Population
The prevalence of constipation in the population is comparatively high around 15%, with a higher prevalence in the female population and in elderly people. In one study investigating almost 15 000 women, 14% to 27% were found to be constipated, highest prevalence in elderly people. Walking less than 0.5 km a day increases the risk of constipation in elderly people, but the role of exercise in the treatment has been challenged. There seems to be strong beliefs, within both medical professionals and the general population that dietary fibre intake should be around 35 g of fibre a day, and it has been documented, that this volume increases the frequency of defecation. Reports are not unanimous in respect of preventing or changing the course of constipation with dietary fibre, and the beneficial effects in treatment in neurological diseases are not evident.
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Symptoms And Warning Signs
Symptoms of Parkinsons fall into two major categories: those related to motor functions, and those related to changes in someones mood. The four most common signs and symptoms of Parkinsons disease include:
- Trembling: This usually presents itself in the arms, jaw, legs and face.
- Rigidity: Most patients experience stiffness of the bodys core as well as their arms and legs.
- Bradykinesia: This is the term for slowness of movement. Some patients pause or freeze when moving without being able to start again, and others begin to shuffle when trying to walk.
- Postural instability : This results in loss of strength, loss of balance and problems with moving muscles or coordinating body parts.
Other symptoms that can also occur, which often impact someones moods and other behaviors, include:
- Sexual dysfunction
A Constipation In Stroke
Constipation and stroke seems associated, yet no studies have been able to show a direct association either clinically or pathophysiologically. However, the number of studies in this field is limited. It is a general experience, that constipation is frequent in acute admitted stroke patients. There may be several explanations for this: the patients are elderly, often treated with a number of drugs, dehydrated, and immobile already at admittance. Box 1 lists a number of drugs, which themselves or in combination may induce constipation. Bed rest and immobility often give rise to constipation, and may in addition induce deconditioning, resulting in inadequate force to defecate.
Hypovolemia is a common problem, both before and after stroke, the latter as a result of dysphagia and/or impaired thirst mechanisms and lack of attention to drinking possibilities. Diet may be another problem, as the hemiplegic population often has an insufficient intake of dietary fibre.
Lesions affecting the pontine defecatory centre may disrupt the sequencing of sympatical and parasympathical components of defecation, and impair the coordination of the peristaltic wave and the relaxation of the pelvic floor and external sphincter.
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Strengths And Limitations Of This Study
This study will be one of the rare randomised controlled trials to assess the clinical efficacy of electroacupuncture in the treatment of constipation in Parkinsons disease .
In order to optimise the credibility of the research results, a multicentre trial will be utilised for this study.
In addition to evaluating the clinical efficacy of EA in the treatment of constipation in PD, this study will also investigate whether EA can play a role in maintenance therapy.
This study will not include a sham EA group. Without blinding patients, the placebo effect of EA treatment cannot be ruled out.
Abdominal Massage For The Relief Of Constipation In People With Parkinsons: A Qualitative Study
Objectives. To explore the experiences of people with Parkinsons who suffer from constipation, the impact this has on their lives, and the effect of using lifestyle changes and abdominal massage as a form of constipation management. Method. Fourteen semistructured interviews were completed at the end of a care programme, which consisted of either lifestyle advice and abdominal massage or lifestyle advice only . Data were analysed using constant-comparison techniques and Framework methods. Themes and key quotes were identified to depict major findings. Findings. Four key themes were identified: the adverse impact of bowel problems on quality of life positive experience of behaviour adjustments: experimentation abdominal massage as a dynamic and relaxing tool: experiential learning abdominal massage as a contingency plan: hesitation . Constipation was reported as having a significant impact on quality of life. Participants in both groups perceived lifestyle advice to relieve symptoms. Specific improvements were described in those who also received the abdominal massage.Both lifestyle advice and abdominal massage were perceived to be beneficial in relieving symptoms of constipation for PwP.
It was concluded from the quantitative analysis that abdominal massage as an adjunct to treatment of constipation offers a potentially beneficial intervention to PwP.
2.1. Study Design and Sample
2.2. Ethical Approval
2.3. Data Collection
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