The first step in dealing with bowel disorders is to identify the problem and seek advice. Your doctor will probably review your medication to see if this is a contributory factor. Whilst it is usually possible to control any difficulties with diet, fluid intake and exercise, your doctor or Parkinson’s Disease Nurse Specialist will be able to advise further, and may, for example, prescribe laxatives in severe cases of constipation.
The following healthcare professionals can also advise on aspects of bowel care:
- a dietician will be able to advise on diet and fluid
- a physiotherapist may be able to help with advice and abdominal exercises which will help in passing stools
- a speech and language therapist can help with swallowing problems. They may be able to advise on ways of relaxing your throat, and give guidance on posture and exercises to help overcome any difficulties you have
- an occupational therapist may also be able to suggest practical ways to overcome any difficulties you have with eating and drinking.
Laxatives
Very often constipation can be controlled through diet, fluid intake and exercise but if this does not work, then laxatives may be helpful in managing the problem. But they should be used with caution and only under the direction of a doctor, because some may cause permanent damage to the bowel.
There are several types available including fibre-based laxatives and ‘osmotic’ laxatives which draw water into the bowel and retain it there to soften and bulk up stools, so making them easier to pass. One such example is Movicol®, a solution which delivers water to the large intestine, increasing the bulk of the stool. This triggers the muscles of the bowel to contract and produce a bowel movement. The water in Movicol solution is not absorbed into the body so it can also soften and lubricate the stools to promote comfortable bowel movements.
It is crucial that, at first, your doctor checks regularly that the dose of any laxative is right for you. Once this is achieved, you will probably be able to maintain the right balance on a day-to-day basis, taking account of what you do and how you feel from one day to another.
When oral laxatives have not been successful, enemas (a liquid inserted into the rectum through a tube, usually with the aim of triggering bowel movement and the passage of stools) can be very effective in improving severe constipation.
