>>> Carol Horner <[log in to unmask]> 06/04/97
05:15pm >>>
>>> greatly worsening conditions<<<
>>>I do have one question<<<
>>>For about two years I have noticed that when things got
really bad, and that included a 4-week hospital stay (2 of it in
the rehab dept.) they were precipitated and/or concurrent
with bowel problems. . . .what to do about the constipation is
not my question. . . . What I would like to know is if others
have seen such a direct correlation between poor elimination
and drastic worsening of symptoms?
[log in to unmask]<<<<
Hi Carol:
I am not clear about what you mean by "greatly worsening
conditions" or "when things got really bad" or what the
conditions were that required your husband's 4 week
hospital/rehab stay or how, in your observation, those
conditions were "precipitated. . ." by ". . . bowel problems."
The gastrointestinal tract is part of the body's autonomic
nervous system, whose functions are independent and
self-controlled. Constipation is common with aging, usually
brought about by lack of dietary fiber/roughage, reduction in
fluid intake and diminished physical movements. These
factors contribute to a slowdown in the movement of food
through the intestines (motility).
The PD patient has a further complication: medications.
Patients taking Levodopa and anticholinergics (Artane,
Cogentin, Parsidol) commonly report dryness of the mouth
and constipation. Dopamine agonists (apomorphine,
bromocriptine [Parlodel] ) delay emptying of the stomach.
This in turn leads to poor assimilation of levodopa, leading to
problems with motor functions.
If improved intake of fiber and water combined with an
increase in physical activity do not improve the condition,
milk of magnesia or enemas can be tried. The medications
Cisapride or Domperidone are usually prescribed to improve
motility and stomach emptying leading to better absorption of
the levodopa.
Recent clinical studies have suggested that in PD
dopamine neurons which connect with the bowel are
compromised or lost leading to a failure of the bowel to
receive brain information (such as contractions).
Stephan 52/6
