Side Effects of PD Bladder and Bowel Dysfunction
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Parkinson’s disease aka PD does not only affect motor coordination but also some of the activities that the autonomic nervous system takes care of involuntarily like body elimination. Many PD sufferers have bowel and bladder dysfunction that can affect their quality of life. Bowel function in particularly can be particularly distressing to patients.
Bowel Dysfunction
Constipation is a major factor with Parkinson’s patients and is defined by having fewer than 3-4 bowel movements per week. Once food leaves the stomach and enters the intestines is where the trouble starts. The colon could be working lethargically, pushing the food through slowly thus causing in frequent bowel movements. Treatment requires the changes in diet or taking supplements that work to increase colonic movement.
Doctors will suggest Parkinson’s patients with constipation problems increase fiber intake to 25-35 grams per days either through food intake or fiber supplements as well as increase fluid intake water being preferable. When upping the fiber and fluids does not work, doctors may suggest a stool softener to loosen the consistency of the bowel movement. The next step in the constipation game when stool softeners and increased fiber and fluids do not work is taking a drug that drags fluid into the colon. Colon cleansing is the next step in relieving constipation symptoms in PD patients but it must be done under a doctor’s care. The last resort is enemas that must also be completed under a doctor’s care.
Sometimes the act of bowel elimination itself is the problem; therefore all efforts to relieve constipation are useless. Some PD patients may strain or not completely empty during a bowel elimination which can be traced back to the sphincter muscle in the rectum not relaxing enough to allow elimination. Muscles may spasm and there are few treatments for this that work. Special injections like Botox have met with limited success but testing is underway to see what else can be done to relieve this problem.
Urinary Tract Dysfunction
Up to 40-60% of PD patients experience urinary and bladder difficulties; however incontinence itself is not as common. These problems usually do not manifest themselves until later in the disease. The bladder works in two ways it stores urine as it is created and then it empties when it is time to do so. However, with PD, bladder function may become impaired.
Many PD patients feel the need to go to the bathroom frequently and they may also have difficulty holding the urine in until they can get to a bathroom to do so. The brain is telling the bladder that it is full and needs to be emptied, when in fact it is not full. This causes frequent interruptions in sleep which leads to fatigue, another common symptom of Parkinson’s.
Luckily, there are medications that can help relieve an overactive bladder. Of course, physical aspects such as the muscles used to hold in the urine and release it may be a problem as well. Muscle spasms and inability of the urinary sphincter may occur preventing the complete elimination of urine. Unfortunately, like with the bowel dysfunction, there is not much that can be done in terms of relieving these muscle coordination problems. The bottom line though is seeking treatment immediately should some bladder or bowel dysfunction should occur. Catching it early for treatment can delay its progression.
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