Opioid-induced constipation https://hellocaremail.com.au/side-effects-pain-medications-know-manage/ is the most common medication side effect, occurring in 40% to 95% of people taking opioid analgesics.
Please note that Parkinson’s disease is a progressive, degenerative neurological condition that affects the person’s ability to control their body movements. Symptoms result from the degeneration of nerve cells in the middle area of the brain, which causes a deficiency in the availability of dopamine. Dopamine is a brain chemical necessary for smooth, controlled movements.
The symptoms of constipation include:
A range of causes
The ways in which Parkinson’s disease can increase the risk of constipation include:
Complications of chronic constipation
Chronic constipation can cause further problems including:
Diagnosis
Diagnosis of constipation may include:
Treatment
Your doctor may suggest various treatments to help combat constipation, including:
Self-help suggestions – dietary fibre
Be guided by your doctor, but general suggestions include:
Foods that help (by bulking stool and being soft and easy to consume):
Self-help suggestions – exercise
Be guided by your doctor, but general suggestions include:
Self-help suggestions - sleeping on an inclined bed
Poop: What's Really in It
Water makes up about 75 percent of your stool. The rest is an often-stinky combination of fiber, dead and live bacteria, other cells, and mucus. Soluble fiber found in foods like beans and nuts is broken down during digestion and forms a gel-like substance that becomes part of your poop.
On the other hand, foods packed with insoluble fiber, such as corn, oat bran, and carrots, are more difficult for your body to digest, which explains why they may emerge in your poop (stool) looking relatively unchanged.
Color Matters When It Comes to Poop (Stool)
As you may have seen in pictures of poop, the color can vary — a lot — depending on what kinds of food you’ve ingested and other factors. Dr. Sheth has seen patients get full work-ups for bright red stool that turned out to be nothing more than the passing of beets. Leafy vegetables can cause green stool, while certain medications can make your poop look white or clay-colored. Look out for jet-black stool. Though it could be from something as harmless as iron supplements or black licorice, the color could be a sign of bleeding in the upper gastrointestinal tract.
It can be hard to describe your poop, so doctors use a scale to show the different kinds. It's called the Bristol stool chart and it gives you an idea of how long a stool spent in your bowel before heading out.
with deep appreciation of this most sensitive subject:
https://www.medicinenet.com/digestive_disorders_poop_type_color/article.htm
Self-help suggestions – toilet habits
Be guided by your doctor, but general suggestions include:
Seek immediate medical attention if:
Remember
- Unlike other side effects, constipation typically persists for the duration of opioid therapy and requires monitoring and proactive management.Constipation can occur even when taking a low dose of opioids.
Increased agitation is another side effect due to constipation in the elderly. Some people are reluctant or embarrassed to report constipation. Monitoring bowel habits is important when taking opioids as it doesn’t take much for the older person to become constipated causing more serious side effects. - for example: Constipation is a common complication of Parkinson’s disease and can be experienced in other illnesses, but it can be managed with:
- medical treatment,
- extra fibre in the diet
- and lifestyle changes
- Constipation can usually be diagnosed based upon your symptoms and a physical examination. You should also mention any medications you take regularly since some medications can cause constipation
- You may need a rectal examination as part of a physical examination. A rectal examination involves inserting a gloved finger inside the rectum to feel for any lumps or abnormalities. This test can also check for blood in the stool
- http://www.uptodate.com/contents/constipation-in-adults-beyond-the-basics
Please note that Parkinson’s disease is a progressive, degenerative neurological condition that affects the person’s ability to control their body movements. Symptoms result from the degeneration of nerve cells in the middle area of the brain, which causes a deficiency in the availability of dopamine. Dopamine is a brain chemical necessary for smooth, controlled movements.
The symptoms of constipation include:
- Dry and difficult to pass bowel motions (poo)
- Less than three motions a week, on average
- Feeling the need to strain on the toilet
- The bowel doesn’t feel empty afterwards.
A range of causes
The ways in which Parkinson’s disease can increase the risk of constipation include:
- Insufficient dopamine – lack of the brain chemical (neurotransmitter) dopamine impairs muscle movement throughout the body. Bowel muscles can become slow and rigid.
- Uncoordinated bowel – the bowel muscles may be weak and unable to contract or they may clench instead of relax when trying to pass a motion.
- Eating problems – dietary fibre is indigestible, so it adds bulk to the bowel motions and prevents constipation. However, if chewing and swallowing are difficult, a person with Parkinson’s disease is less likely to eat fibrous foods.
- Drinking problems – water is needed to plump the dietary fibre in bowel motions. Swallowing difficulties may discourage the person with Parkinson’s disease from drinking enough fluids.
- Sedentary lifestyle – lack of exercise slows the passage of food through the intestines. Parkinson’s disease reduces muscle control, so lack of exercise is common.
- Medications – many different drugs can cause constipation. Medications used in the treatment of Parkinson’s disease (especially anticholinergic drugs) may slow bowel movements or dampen appetite.
Complications of chronic constipation
Chronic constipation can cause further problems including:
- Lethargy
- Nausea
- Abdominal pain
- Twisted bowel
- Obstructed bowel
- Bowel incontinence (leakage or diarrhoea)
- Urinary incontinence (caused by pressure against the bladder)
- Urinary tract infections.
Diagnosis
Diagnosis of constipation may include:
- Medical history
- Detailed description of symptoms
- Physical examination.
Treatment
Your doctor may suggest various treatments to help combat constipation, including:
- Dietary changes including consuming more fibre and water
- Moderate exercise
- Good toilet habits
- Avoiding unnecessary medicines that contain substances known to cause constipation such as calcium and aluminium
- Short-term course of laxatives
- An enema – this may be part of the initial treatment
- Treatment for any medical problem that may be contributing to the constipation, such as haemorrhoids.
Self-help suggestions – dietary fibre
Be guided by your doctor, but general suggestions include:
- Choose easy-to-eat fibrous foods such as soft fruits. Consider mashing or pureeing fruits to make them easier to eat. Make sure to include the skin, where most of the fibre is found.
- Eat homemade vegetable soups.
- Sprinkle a tablespoon of bran on your breakfast cereal or add the bran to baked products such as cakes. However, bran should be avoided if you have swallowing problems.
- Fibre supplements may be helpful. However, you must drink enough fluids for the supplements to work properly. Avoid fibre supplements if you have swallowing problems.
- Don’t increase dietary fibre too quickly or you’ll risk bloating and abdominal cramps. If discomfort occurs, cut back your fibre intake, increase your fluid intake, apply a hot water bottle to the abdomen and see your doctor.
- At some point, both urinary and fecal (bowel) incontinence affect most people with dementia as brain-body communications deteriorate.
- Diet can influence the types of stools you have to deal with.
Foods that add to the problem (by relaxing the anal sphincter or irritating the bowels): - Coffee
- Tea
- Chocolate
- Cured or smoked meat
- Spicy foods
- Ice cream
- Milk
- Fatty or greasy foods
- Fruit
Foods that help (by bulking stool and being soft and easy to consume):
- Bananas
- Rice
- Tapioca
- Applesauce
- Yogurt
- Oatmeal
Self-help suggestions - fluid intake
- Try to drink six to eight glasses of fluid every day. Water is the best drink.
- Avoid drinks that cause dehydration such as tea, coffee and alcohol.
- Spread your drinks throughout the day.
- Cut back on milk drinks, as milk can cause constipation in some people.
Self-help suggestions – exercise
Be guided by your doctor, but general suggestions include:
- Consult closely with your doctor, physiotherapist or health care professional when devising your exercise program.
- Aim for at least 15 minutes of exercise every day.
- Spend a few minutes warming up and cooling down. This could include marching in place or stretching.
- Start with the easiest exercises first. Slowly introduce the more difficult exercises as your fitness increases.
- Only exercise when other people are at home who can help if necessary.
Self-help suggestions - sleeping on an inclined bed
- Our entire digestive tract is composed of a single tube running from our mouth to anus. When we are inclined in bed (shows graphic drawing of how food moves down the digestive system), no matter which position we sleep in, gravity is positively acting upon the digestive system by helping to move food more quickly, which helps to prevent Constipation and diarrhoea and avoid scybala (Hardened masses of faeces) from causing a blockage in the colon. Note: The rectum lies towards the end of the colon where it plays an important role is temporarily holding feces before a bowel movement. Like any part of the bowels, the rectum may become blocked. As a result the movement of stool is hampered and a person may experience this blockage as constipation.
- Without intervention, a blocked rectum can become a serious condition and even lead to tearing of the bowel walls. Go Immediately to the Hospital Emergency Department - like NOW!!!
- Impacted Bowel – Causes and Symptoms of Colon Stool Impaction
Poop: What's Really in It
Water makes up about 75 percent of your stool. The rest is an often-stinky combination of fiber, dead and live bacteria, other cells, and mucus. Soluble fiber found in foods like beans and nuts is broken down during digestion and forms a gel-like substance that becomes part of your poop.
On the other hand, foods packed with insoluble fiber, such as corn, oat bran, and carrots, are more difficult for your body to digest, which explains why they may emerge in your poop (stool) looking relatively unchanged.
Color Matters When It Comes to Poop (Stool)
As you may have seen in pictures of poop, the color can vary — a lot — depending on what kinds of food you’ve ingested and other factors. Dr. Sheth has seen patients get full work-ups for bright red stool that turned out to be nothing more than the passing of beets. Leafy vegetables can cause green stool, while certain medications can make your poop look white or clay-colored. Look out for jet-black stool. Though it could be from something as harmless as iron supplements or black licorice, the color could be a sign of bleeding in the upper gastrointestinal tract.
It can be hard to describe your poop, so doctors use a scale to show the different kinds. It's called the Bristol stool chart and it gives you an idea of how long a stool spent in your bowel before heading out.
with deep appreciation of this most sensitive subject:
https://www.medicinenet.com/digestive_disorders_poop_type_color/article.htm
Self-help suggestions – toilet habits
Be guided by your doctor, but general suggestions include:
- Go to the toilet as soon as you feel the urge to pass a bowel motion. Avoid hanging on.
- Use correct body posture on the toilet – it can help you pass a bowel motion. Place your elbows on your knees and put your feet on a footstool.
- Avoid holding your breath and don’t strain when you are on the toilet. Allow yourself plenty of time.
- Use a warm washcloth pressed against your anus or gentle massage with one or two fingers to help to relax the muscles.
- Talk to your doctor about medicines to help soften your motions.
Seek immediate medical attention if:
- Constipation develops suddenly
- You have bloody bowel motions
- Passing a bowel motion causes pain
- You have unexplained weight loss
- Constipation is still there after three weeks despite your best efforts.
- Where to get Help
- Your GP
- Your neurologist
- Your local continence clinic or service: OzCare, Gold Coast Continence Unit Phone 07 5569 6200 Mob 041 775 1813
- National Continence Hotline Phone 1800 330 066
- CAPS Payment assists people with permanent and severe incontinence some of the costs of their continence Phone 1800 33 00 66
Remember
- Constipation is a common complication of Parkinson’s disease and can occur with other illnesses also.
- Constipation can be managed with appropriate medical treatment, extra fibre in the diet and lifestyle changes.
- See your doctor if the constipation does not resolve within three weeks, despite your best efforts.