As we all know there are many side effects of our meds. The least of these being GI symptoms. My problems are what I call "partial bowel obstructions". It begins with a small bowel movement-loose. Followed by constipation then alot of diarrhea. This happens maybe 1-2x a month, otherwise I stay pretty regular but more to the side of constipated till the diarrhea hits. All of this is compounded by the fact that it seems that I get little warning-it feels like I've gotta go NOW and then wham. This makes it less than pleasant to go out for the day. I usually ruin at least 2 pair of underwear a month, leading me to use these depends garments. I have tried to deal with this as an IBS issue but I still get little warning. Docs have suggested more vegs, water for regularity, etc. and I know I need to do better but it's very frustrating.

Jim,

I haven't heard of any lower GI side effects of meds. I do know that anticholinergics like Amantadine cause or exacerbated constipation. I am fairly atypical in this area, as in I'd say I'm a little slow but not full blown.

Are these extreme fluctuations happening near med dosages? If not, maybe time to check in with your regular doc, It is easy to think everything is PD related but not always the case. It could be something else that is easily treatable.

Laura

There seems to be a pattern so i'd keep notes with dates to show him. IT should help him/her a lot.
Constiiipation is a major problem ; i must eat certain things and wait. I can go to a conference and not go the whole time.

yep, we're having a cheerful time discussing elimination but at least it isn't the weekend......lol

Entacapone also known as Comtan or Comtess, and Stalevo are known to cause diarrhoea (It is in the side-effects leaflets). When this happens it is recommended to discontinue the medication as the problem is unlikely to resolve. If you are on one of these medications it might be a good idea to consult your neuro. I was advised of this when I was started on entacapone.

Hoping you find a good solution to your problem

Lindy

Not trying to be funny - just getting your attention. This is an excellent but seldom discussed topic.
Constipation is a "side effect"' of having Parkinson's. We don't move as much, which really slows down the digestive tract. Also, many of us take anti-depressants, many of which cause constipation as a side effect.

I won't name them all, but most PD meds lend to diarrhea or constipation..

I know you mentioned diarrhea, but that can be a result of having constipation (Keep reading - it gets more confusing!) Many PD patients get "impacted" - sort of plugged up. This causes leakage or diarrhea around the impaction.

Impaction of the bowel can be lethal! In fact, it is one of the leading causes of PD death . Below are some excerpts from side effect listings of some commonly used PD drugs.

Straight from the rxlist.com website:
NOTE! The side effects listed does not mean you will definitely have them; this is just a list of potential side effects. you may look up these side effects or interactions yourself at the above website.

Side effects of:

Sinemet or carbidopa/levodopa: Gastrointestinal: dark saliva, gastrointestinal bleeding, development of duodenal ulcer, anorexia, vomiting, diarrhea, constipation, dyspepsia, dry mouth, taste alterations.

Requip/Mirapex: in order of decreasing incidence: nausea, dizziness, somnolence, headache, vomiting, syncope, fatigue, dyspepsia, viral infection, constipation, pain, increased sweating, asthenia, dependent/leg edema, orthostatic symptoms, abdominal pain, pharyngitis, confusion, hallucinations, urinary tract infections, and abnormal vision.
Comtan/
In clinical trials, diarrhea developed in 60 of 603 (10.0%) and 16 of 400 (4.0%) of patients treated with 200 mg Comtan and placebo, respectively. In patients treated with Comtan, diarrhea was generally mild to moderate in severity (8.6%) but was regarded as severe in 1.3%. . . . . Diarrhea generally resolved after discontinuation of Comtan. . Typically, diarrhea presents within 4 - 12 weeks after entacapone is started, but it may appear as early as the first week and as late as many months after the initiation of treatment. Diarrhea may be associated with weight loss, dehydration, and hypokalemia.

Post-marketing experience has shown that diarrhea may be a sign of drug-induced microscopic colitis, primarily lymphocytic colitis. . . .

If prolonged diarrhea is suspected to be related to Comtan, the drug should be discontinued and appropriate medical therapy considered. If the cause of prolonged diarrhea remains unclear or continues after stopping entacapone, then further diagnostic investigations including colonoscopy and biopsies should be considered.
These possible side effects also apply to Stalevo.

Artane: Potential side effects associated with the use of any atropine-like drugs, including Artane, include cognitive dysfunctions, including confusion and memory impairment; constipation, drowsiness, urinary hesitancy or retention, tachycardia, dilation of the pupil, increased intraocular pressure, choreiform movements, weakness, vomiting, and headache.

WHAT TO DO: The following is prescribed for PWP:

Exercise - just walk, twist your torso, stretches, anything - but don't be stagnant - movoe as much as you can.

Eat roughage (celer y, fiber, leafy veggies,, fruits like plums, apples, oranges.

Drink water every time you think about it.

Keeping your colon "clean" also helps prevent toxicity of the drugs we ara required to take.

This is one of the more embarrassing PD symptoms. Nothing like being out in public and having a sudden uncontrollable "attack."

But what Jim described doesn't sound like microscopic colitis. My husband (who doesn't have PD) suffers from microscopic, lymphocytic colitis and it is not characterized by periods of constipation. It is all diarrhea - all the time. His was diagnosed after a colonoscopy and biopsies. Meds are VERY expensive, but we have found that probiotics (acidophilus, etc.) help. He needs a high dose in pill form.

On the PD side of things, I have a similar problem to Jim and (on my doctor's recommendation) have found that a low dose every day of FiberCon or generic fiber laxative helps. It absorbs the excess fluid, creates bulk, and helps with regularity. I take one before bed and one in the afternoon, if I think of it. No need to take the full dose recommended on the bottle, but it's important to take a low dose every day. If I forget, I'm in trouble.

All of Peg's recommendations are good!

J:-)

Many drugs can cause the symptoms you describe. For me the use of Tylenol 3 as well as Coumadin does the damage. When the stool becomes impacted it is natural for the water to accumulate behind it and cause diarrhea. But it is the first instance of constipation that can do the harm. I tried all that the doctors told me till one told me it was attaining more movement that was my problem and many others suffered the same way.

He said I should take a stool softener at least once a week and more if becoming that way again, because food can sometimes be a source of the problem for me.

Well I did, and the problem is gone and has been for over 7 months now. The softener keeps both problems in the condition they need to be. With the first bout of Chemotherapy it was a big problem, lol sorry. Starting third round on the 7 of January I will be in much better shape for the problems it incurs for me.

Try it for a week or so and you can't hurt yourself if you don't use more than 3 per week. If you need more than see your Doctor for sure.

I really hope this helps you as it has me.

Thelma

Jim I understand this problem, I have had 'urgency' for so long - years before diagnosis and treatment. I wonder if the two issues-

gotta go now, and
alternate constipation then diarrhea

are two separate but interconnected problems.

I also have urgency of micturition so I have thought this could be a lack of muscle tone issue. Unfortunately starting medication has not improved things. Thanks for posting on this topic.

A few months before my dx I developed frantic urgency of micturition and my Doctor prescribed "Detrusitol (tolterodine tartrate)prolonged release capsules, hard" and they knocked the problem right on the head. Worth a try.

Yes we lose control of the peripheral nervous system as time goes on. I take narcotics for pain, so that's double trouble, and am only somewhat regular if i eat 6 pieces of toast and drink warm liquids. EVERY day. have tried everything, Sennocot, Stool softeners, bisacodyl products, just make my lower gut sore, but only a good mixture of both water soluble and "long" fibers in the diet, and lots of water help in my case. And KEEP MOVING, exercise is one of those things we parkies want to natually avoid. and force yourself to swallow more (chew gum), we tend not to. this gets peristaltic waves going through the length of the gut, and forces material to move along little doggies! cs