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Dear Helen,

You note that the constipation problem  that you've described seems to
have worsened since a BA-enema 2 weeks ago.

A similar thing happened to a family member of mine (who has PD) who at the
time was in the hospital for pneumonia complicated by PD. Because of serious
constipation and abdominal distension, they tried to find out the cause by
doing an upper- and lower-GI series, which of course included BA-enema.

Apparently some of the BA was not thoroughly excreted, and, because BA can
gradually solidify inside the colon after awhile, it seemed to intensify
her constipation at the time.

I was distressed to learn that although I had often urged the doctors and
nurses to keep close track of getting this BA out so as to prevent that
problem from arising, they apparenty did not pay close enough attention
to doing this until, just as I feared, it became a problem.

Then, eventually, they did get it out, over time, by being sure that my
family member got the appropriate amount of liquids regularly, plus
certain laxatives such as Cascara & Milk of Magnesia and others. An
important consideration in their selection of types of laxatives was
whether or not there was solid blockage -- in such a situation, certain
types of laxatives or such medications as Propulsid (which would make the
intestines push harder) might instead have been dangerous to the
integrity of thre intestinal wall.

But fortunately, over a time, all that remaining-barium did come out
and the problem resolved.

So I (as a layman -- I'm not a doctor) would advise you that the problem
you've described ought to be treatable but should be done under a doctor's
close guidance as to choice of laxatives/medications. I would ask your
doctor if he/she would consider, as a starting-point, some sort of exam --
whether colonoscopy, or abdominal x-ray, for example -- to determine
whether or not the problem is being caused by any substantial amounts of
residual barium in the colon. I would also inquire as to whether or not
the physical stress of undergoing the BA-enema process itself may have
perhaps (this is just my guess) temporarily traumatized the intestinal
musculature.

Good luck.

-- SJS
   1/28/97