Best Laxatives For Parkinson's: Safe And Effective Relief

Constipation is a common symptom of Parkinson's disease, affecting up to two-thirds of patients. It can cause discomfort and impact the effectiveness of Parkinson's medications. The condition occurs when bowel movements become difficult or less frequent, often due to the improper functioning of the autonomic nervous system, which regulates smooth muscle activity. While there is currently no specific method for preventing constipation in Parkinson's patients, there are several treatment options available, including dietary and lifestyle changes, as well as medications such as laxatives and stool softeners.

Causes of constipation in Parkinson's patients

Constipation is a common complication of Parkinson's disease, with up to two-thirds of patients experiencing it. It can cause discomfort and impact the effectiveness of Parkinson's medications. Constipation in Parkinson's patients can be caused by a variety of factors, including:

• Parkinson's disease itself: The same changes that occur in brain cells in Parkinson's disease may also occur in nerve cells in the spinal cord and intestinal wall, slowing down the muscles that push food through the intestines.
• Medications: Drugs used to treat Parkinson's, such as anticholinergics, amantadine, levodopa, dopamine agonists, and trihexyphenidyl, can cause constipation.
• Decreased physical activity: Parkinson's disease can lead to reduced physical activity, which can slow down the digestive system.
• Decreased water intake: Parkinson's patients may limit their fluid intake to avoid frequent trips to the bathroom, but this can contribute to constipation.
• Genetic predisposition: Constipation can also be influenced by genetic factors, and some people may have a family history of constipation.
• Individual body chemistry: Each person's body is unique, and factors such as diet, fluid intake, and exercise can impact constipation.

Lifestyle changes to treat constipation

Constipation is a common complication of Parkinson's disease. It is often experienced before the onset of motor symptoms and can be caused by the disease itself or by the medications used to treat it. Here are some lifestyle changes that can help treat constipation in Parkinson's patients:

• Increase fluid intake: Drink at least six to eight 8-ounce glasses of water or other fluids per day. Limit drinks that cause dehydration, such as alcohol, tea, and coffee.
• Eat more fibre: Consume more whole grains, fruits, and vegetables. Try to eat at least two pieces of fruit and five servings of vegetables every day.
• Exercise regularly: Aim for at least 30 minutes of exercise every day, including abdominal muscle movement to help activate the digestive system.
• Establish a daily routine: Try to have a bowel movement at the same time each day, preferably 15-45 minutes after breakfast.
• Improve toilet habits: Go to the toilet as soon as you feel the urge to pass a bowel movement. Use the correct posture on the toilet, such as placing your feet on a footstool. Avoid holding your breath and straining.
• Warm liquids: Drink warm liquids, especially in the morning, as this can stimulate a bowel movement.
• Smaller meals: Some people find that eating smaller meals throughout the day helps with constipation by allowing more time for digestion.

Dietary changes to treat constipation

Constipation is a common issue for people with Parkinson's disease. It is often caused by the disease itself, as Parkinson's can affect the nervous system, slowing down the intestinal tract. Constipation can also be a side effect of Parkinson's medication.

The first steps in treating constipation are always diet and lifestyle adjustments. Here are some dietary changes that can help treat constipation:

• Drink more water: Dehydration is a common cause of constipation. Drinking plenty of water can help to ease or resolve constipation. The large intestine draws water out of the stool before it is passed out of the body, so if you are dehydrated, your stool can become hard and dried out, making it more difficult to pass. It is recommended that people with Parkinson's drink 48–64 ounces (6–8 cups) of water per day.
• Eat more fibre: Fibre is a major component of foods that relieve constipation. It adds bulk to the stool and provides other digestive benefits. Fibre supports the microbiome (the healthy balance of bacteria in the digestive tract) and helps gut motility (the coordination of muscle contractions in the intestines that push food along the digestive process). It is recommended that women eat 25–30 grams of fibre a day, and men 30–38 grams. Good sources of fibre include whole grains (such as whole wheat bread and pasta, oatmeal, and bran flake cereals), legumes (such as lentils, black beans, kidney beans, soybeans, and chickpeas), fruits (such as berries, apples with the skin on, oranges, and pears), vegetables (such as carrots, broccoli, green peas, and collard greens), and nuts (such as almonds, peanuts, and pecans).
• Eat more probiotic foods: Probiotics are beneficial bacteria that may help to improve gut health and soften stools. Probiotic foods include yoghurt, kefir, and sauerkraut.
• Eat more high-fibre fruits: High-fibre fruits that may help to ease constipation include kiwifruit, apples, pears, grapes, blackberries, and raspberries.
• Eat more whole wheat products: Whole wheat products are an excellent source of insoluble fibre. Wheat bran, for example, is rich in insoluble fibre and can be eaten as a cereal or added to other foods, such as soup.
• Eat more pulses: Beans, lentils, and peas are very high in fibre.
• Eat smaller meals throughout the day: Some people find that eating smaller meals helps with constipation, as it allows more time for digestion.

If dietary and lifestyle changes are not enough to ease constipation, a doctor may recommend over-the-counter or prescription medications, including stool softeners, laxatives, or enemas.

Over-the-counter medications to treat constipation

Constipation is a common symptom of Parkinson's disease, affecting up to two-thirds of patients. It can cause discomfort and impact the effectiveness of Parkinson's medications. While there is currently no specific treatment for Parkinson's-related constipation, there are several over-the-counter medications that can help.

Bulk-forming laxatives

Bulk-forming laxatives, such as psyllium (Metamucil), methylcellulose (Citrucel), and polycarbophil (FiberCon, Konsyl), are high in fibre and help add bulk to the stool. They can be taken orally, usually mixed with water or juice, once or twice a day.

Stool softeners

Stool softeners, such as Colace and Docusate, help to soften the stool by facilitating the admixture of fat and water. They are usually taken orally once or twice a day, and should not be used with mineral oil.

Lubricants

Lubricants, such as mineral oil, help to lubricate the stool and facilitate its passage through the intestine. They are usually taken orally, following the instructions on the package.

Stimulants

Stimulant laxatives, such as Correctol and Dulcolax, promote muscle contractions in the digestive tract, helping to move the stool along. They can be taken orally or as a suppository and are usually taken as needed. However, they may cause cramps and are not recommended for daily use.

Osmotic laxatives

Osmotic laxatives, such as Miralax (polyethylene glycol), work by pulling water into the colon, making it easier for the stool to pass. They are usually taken orally, mixed with water or another liquid, once a day or as needed. They are generally gentle and well-tolerated but may cause loose stools or diarrhoea if overused.

It is important to note that these over-the-counter medications should be used with caution and only after consulting a doctor or healthcare provider. They may have side effects, and their effectiveness may vary depending on the individual. Additionally, it is essential to make dietary and lifestyle changes, such as increasing fluid intake, consuming more fibre, and engaging in regular physical activity, to help manage constipation effectively.

Prescription medications to treat constipation

Constipation is a common issue for people with Parkinson's disease, and it can be uncomfortable and distressing. While there are no prescription drugs specifically for treating constipation in Parkinson's patients, there are a variety of prescription medications that can be used to treat constipation more generally.

If constipation is a persistent issue, your doctor may recommend prescription medications. These medications work in different ways and include:

• Osmotics, such as lactulose, which draw water into the bowel to soften and loosen stool. Osmotics can cause side effects such as gas, diarrhoea, an upset stomach, and stomach cramps.
• Linaclotide (Linzess), a daily capsule used to treat chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). It works by drawing water into the intestines to ease stool passage and increase bowel movement frequency. Diarrhoea is a common side effect.
• Lubiprostone (Amitiza), a twice-daily medication taken with food, used to treat chronic constipation and constipation caused by opioids. It softens stool by adding water. Potential side effects include headache, nausea, diarrhoea, abdominal pain, and vomiting.
• Plecanatide (Trulance), a once-daily tablet that helps the body produce fluids in the intestines, aiding stool movement through the bowel. Diarrhoea is a possible side effect.
• Polyethylene glycol (PEG), a powder mixed with water, which adds water to the colon to ease bowel movements. Side effects may include nausea, bloating, cramping, and vomiting.
• Prucalopride (Motegrity), a once-daily tablet that helps increase the rhythmic movements of the colon muscle. Common side effects include abdominal pain or bloating.

It is important to remember that laxatives, even prescription ones, can have side effects, especially with regular or excessive use. Therefore, it is crucial to consult your doctor before taking any of these medications to ensure they are suitable for your individual needs.

Frequently asked questions