Constipation in Parkinson's: Triggers & Treatments

Those of us who live with a chronic illness, such as Parkinson’s disease (PD), know from experience that having a sluggish bowel can be one, if not the MOST devastating, symptom of PD.

Constipation in Parkinson's

In my personal experience, constipation ranks high on the list of the worst symptom to control and to live with. Even though we commonly attribute all of our constipation issues to PD and PD medications with just cause, there are also other common daily culprits which can exacerbate this problem.

What are those common triggers of constipation?

1. Antacids - A sluggish bowel brings frequent heartburn because food is not moving. But some of the medication we tend to use for this problem contains calcium and aluminum, both of which can worsen constipation. Fortunately, there are many other choices we should discuss with our physicians. More importantly, fewer fatty meals and more fiber intake would go a long way in moving things along. Also, a reduction in dairy products tends to decrease heartburn. Many of us mistakenly drink milk when our stomachs are burning; however, this causes an increase in acid production to break down the dairy.
2. Stimulant laxative overuse - Stimulant laxatives include Dulcolax, Ex-lax, and Senokot. What happens when our bowels don’t move? We reach for the laxatives. Unfortunately, if used for an extended amount of time, they can lead to problems and worsen constipation by causing dependence. The best thing I have found is to use OTC laxatives sparingly and get a cocktail of medications from your physician that includes a stool softener to avoid dependence. I use the prescription Linzess every other day because daily use results in tolerance rather quickly along with an ileus (a partial or complete non-mechanical blockage of the small/large intestines).
3. Chocolate - Although, I am a big proponent of dark chocolate consumption for health purposes, especially to boost dopamine, some people believe that eating chocolate makes them constipated. Thus, I would suggest you cut back or eliminate chocolate completely if you think is worsening your constipation.
4. Antidepressants - Antidepressants include tricyclics, SSRIs, and others. Since depression is a common non-motor symptom of PD many of us may use antidepressants. However, some of those antidepressants may cause or worsen constipation. Medications like Elavil, Pamelor, Remeron or even Zoloft can be making your constipation worse so talk to your physician if you are on one of these medications and symptoms of constipation have gotten worse.
5. Medical causes - Just because we have PD does not mean we are immune to other problems like thyroid disease or diabetes, which can worsen constipation.

Now that you know some of the common triggers (aside from Parkinson’s!), you can discuss in detail with your physician about having a good bowel regimen.

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.