Dear Jay and Anne:
Constipation remains one of the most frequent
autonomic-related disorders reported in PD. Lack of daily
fiber, inadequate fluids, lack of physical activity are all
contributory factors. The medications used to treat the
symptoms of PD are also implicated. This includes
levodopa, agonists (Parlodel, Pergolide) [which are thought to
delay stomach emptying time] and anticholinergics (Artane,
Cogentin).
Because conventional methods of dealing with
constipation do not address the neurological changes
caused by PD, doctors have turned to meds. Cisapride,
marketed as "Propulsid," has been shown to be effective in
10mg doses before meals.
It is believed that the problem is in the muscles of the
large intestine. The nerves there receive impulses using
acetylcholine. However, in PD there appears to be damage
to these nerves at the synapse, resulting in delays in bowel
transit time. Cisapride is reported to increase the
acetylcholine to the intestinal muscles increasing intestinal
motility. There are few reported side effects.
Good luck.
Stephan 53/7
