Impact of Parkinsons on bowels

[Guest Posts]

My mum has on off Parkinsons, 9 years diagnosed. It interferes with everything but mostly her bowels. She has problems with muscles not working so pushing out faeces is difficult. She doesn't get the feeling to go. When she does she always says she feels like there is hard lumps of faeces left.
Finally after a couple of years of investigation to no avail she is now awaiting enemas.
The pain she gets from her food not moving well around her system is debilitating and basically her life revolves around this whole issue.
What can she take to help the pain and possibly move the food along.
She takes milled flaxseed, uses suppositories, dulcolese, movicol, laxido, sometimes peppermint tablets. Everything I can find to recommend. She just wants relief so she can have a better quality of life and be able to enjoy food. .with the Parkinsons she has to time and manage when she eats and especially protein as it makes her meds not work correctly.
Any advice or help would be great.
Thank you

[Dr Jamal Hayat]

Hi There,

Parkinson's can cause constipation either as a result of medications used for Parkinson's, and/or due to its affects on colonic motility ie the bowel's muscle strength and shift things along. In addition the swallowing mechanism can get weaker, often meaning intake of fluids goes down - which in turn can exacerbate constipation.

So it is important to encourage a good intake of fluid , fruits and veg and regular exercise to start off with.
However - as you have eluded to do - your mum is doing a lot of these already. There is a ladder of different treatment approaches to treating constipation, and it may be that your mum would benefit from the addition of another medication (such as linaclotide or one called prualopride). This would likely need to be prescribed by a specialist. It would also be worth discussing this with your mum's local Parkinson's disease team to ensure she is on the appropriate anti-Parkinson's medication. I hope you can get the right support (start off with your mum's local parkinson's team - and if they need help they can refer to a gastroenterologist to go through your mum's symptoms and options in more detail.