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Bowel Incontinence Another Embarrassing Casualty of PD: By Dr. De Leon

We all know that since we got diagnosed with PD our bodies don’t work just like they use to; much to our chagrin it does not always respond like we would have it. Sometimes our voice leaves us in the middle of an important conversation with our best friend, other times it cause us to be embarrassed when our fine motor skills betray us and food goes flying across the room especially when we are trying to impress someone we like while on a date. Our handwriting has caused a commotion once or twice at the bank when we have gone to withdraw money because our signature is just not the same! We might have even caused a scene when we unexpectedly tripped on nothing but air. Yet, all of these may pale in comparison it seems when suddenly in the middle of a shopping spree, while driving or simply going about our usual business we lose control of our bowels without warning.

We sit there embarrassed, humiliated, wishing that the earth would suddenly open up and swallowed us whole. Of course it never does so we are left feeling impotent because we may see this as the ultimate sign of PD gaining victory over us.embarresed

What then? Do we cry, do we scream, or simply retrieve to hide under our covers and never come out?

Well, this would not be practical in deed. As foolish as we may feel at the time, I want to tell you that you are not alone in this feeling. So many of us since being diagnosed with Parkinson’s have done many silly things but the truth is that as the song says “we all play the fool sometimes,” with or without PD  sometimes we simply wake up on the wrong side of the bed! Instead of being hard on yourself or refusing to ever go out laugh about it- if you are alone although strangers may seem to stare you will NEVER see them again! Frankly, most people are too busy going about their usual lives to notice such mishaps unless you publicize it! So basically it is us who have to come to terms with this perceived sudden loss of dignity. If you are with friends or family they will understand and be supportive. Best thing to do in any embarrassing situation is laugh after you have composed yourself a bit; this will help ease the feeling of vulnerability!

Okay, now for serious part:

After you have had a big laugh and chucked it up to yet another casualty of PD …then you may wonder why do PD Patients have bowel incontinence? Will it happen to you again?   

First, as we all know Parkinson’s disease affects all of gastric motility function causing it to slow down to nearly a crawl. Compound this effect with the fact that the large consumption of medications make us severely dehydrated and we also have decrease mobility because we are either too stiff, hurting, or off balance to get around with ease, the end result is severe constipation to the point at times of impaction.  Fecal Incontinence as this condition is known where you lose control of your bowels although more common in the elderly can happen to anyone 1/10 people sometimes in their lives. Having Parkinson’s is another risk factor because as I said we do not empty our bowels properly, especially at risk if have feeding tubes.

What can you do to prevent or becoming a hermit your only option?

Since constipation can be so severe or impaction stool can build up behind it and begin to “leak” out around obstruction leading to bowel incontinence. Watch for staining of your underwear, problems reaching toilet in time because of mobility, abdominal bloating or cramping.

  • Main thing to prevent is one make sure there are no other causes like inflammatory bowel disease, diabetes, nerve problems.
  • Then if the problem is getting to bathroom in time have doctor modify your medication regimen to improve mobility.
  • Also, make sure that you maintain a good bowel regimen- includes going to the bathroom daily- using stool if needed and medications both over the counter as well as prescriptions to keep regularity and avoid constipation.
  • Change diet- no caffeine like in coffee or tea; no alcohol; if necessary and get a dietary consult as well as Gi consult.
  • avoid taking Mira lax, fiber tabs or other fiber supplements.
  • Wear depends go to has garments for both men and women that feel and look more natural like underwear.
  • wear the latest “butterfly” pads
  • If all this fails you can have medications to harden stool. Also try behavioral modification (biofeedback).
  • If still having problems there are surgical procedures to tighten muscles around sphincter as well as surgical implant with neuromodulator produced by Medtronic’s called InterStim (sacral Nerve stimulation).

As you can see this can happen to any of us even if  we don’t have PD don’t sweat the small stuff – there a lot of things to help if this is a problem but keep moving forward and not letting PD define who you are!