Here is the corrected Constipation Protocol.
PD Protocol For Prevention of Constipation
NOTES RE: PD PROTOCOL FOR PREVENTION OF CONSTIPATION
The following document was given to us by our internist, who has worked with
us on this problem for some time, and who requested our input and comments.
He has given permission to share it on the list. It was given to him by a
patient, who said the original source was "a computer".
In commenting on the protocol, Peter noted that the book, "Worst Pills, Best
Pills" lists Surfak (stool softener) as a "do not use" medication for "simple
constipation"--not exactly what Parkies have, however. In addition, he
commented that he no longer finds Metamucil helpful, even with LOTS of water,
though it did work at one time. (Nothing seems to work forever!) At present
he has a regimen that works for him MOST of the time, with occasional
relapses. 15 minutes before each meal take one tablespoon of Chronulac (Rx drug also known as Duphalac, generic= lactulose syrup). Thus,
he skips step 1 entirely. Though the internist gave him the Rx for lactulose,
the only instructions were to take it three times a day, and the timing is
Peter's.
We share this protocol with the understanding that everyone is
different--some Parkies don't even have this problem, and some do well with
other remedies, herb teas, Metamucil, etc. Note the detailed instructions for
use of each med., and consult your own doctor, of course, if you wish to try
the Rx meds.
IMPORTANT DISCLAIMER
ALL MATERIAL PRESENTED HERE IS FOR INFORMATION PURPOSES ONLY
AND IS NOT
INTENDED TO REPRESENT DIAGNOSIS, PRESCRIPTION OF MEDICATIONS
OR TREATMENTS,
NOR SPECIFIC PRESCRIBING RECOMMENDATIONS.
PARKINSON'S DISEASE
PREVENTION OF CONSTIPATION
All of the medications utilized in the treatment of Parkinson's Disease tend
to cause constipation which, at times, may become severe. In order to avoid
problems, particularly fecal impaction, the following preventive approaches
are set forth. However, DO NOT use laxatives if there are any signs of
abdominal swelling, pain, or lack of bowel sounds, before consulting your
doctor.
1. Starting Regimen
Prune Juice (4 Oz.) with Breakfast and at Bedtime
Surfak (Docusate Calcium): One 50 mg Capsule at Bedtime
(May be increased up to a maximum of Three 50 mg Capsules)
Warning: DO NOT use Mineral Oil while using Surfak
2. If relief is not forthcoming, at Bedtime add:
Senokot (Senna): Two 8.6 mg Tablets
(May be increased up to a maximum of Eight 8.6 mg Tablets/day)
OR
Senokot (Senna): One Level Teaspoon Granules mixed with water
(May be increased up to a maximum of four Teaspoons/day)
OR
Senokot (Senna): One Suppository (repeat in 2 hours if necessary)
3. If no bowel movement is achieved by the third day, give:
Dulcolax (Bisacodyl): One 10 mg Suppository before Breakfast
4. If no bowel movement is achieved, give:
Magnesium Citrate: 5-10 oz. at Bedtime
5. If no results are achieved by the fifth day, seek the advice of a health
care
professional regarding the use of an appropriate enema.
PATIENT INSTRUCTIONS:
LAXATIVE
DOCUSATE CALCIUM ( SURFAK )
TAKE THIS MEDICATION ACCORDING TO THE FOLLOWING
INSTRUCTIONS:
