Constipation and the role of stool softeners

I have a friend with Parkinson’s who suffers from constipation and has told me for months how he is working to rid stool softeners from his system. I cannot find any info on the topic and don’t know enough about Parkinson’s to offer any advice. I did get him to describe his situation on November 4, 2023 and will include what he wrote below. He is still suffering the same symptoms now. I told him that I would post his summary so it contains no personal information. The remainder of this message contains exactly what he wrote. Any advice or comments are welcome.

I was diagnosed with Parkinson’s 6 years ago. My doctor prescribed sinemet, but did not give me any paperwork about the med. Nearly a year later, I was struggling with constipation. It was over a year after starting sinemet that I finally learned that sinemet causes constipation. Over the course of a few years, numerous visits to urgent care and around a dozen medications, I went through considerable hardship in my effort to clear out my constipation. I’ve had to increase my sinemet intake from 3 to 4 and then 5 tablets a day.

Two years ago, I tried Metamucil fiber, which proved to be quite effective on the sinemet. At that point, I had narrowed down my meds to suppositories for my daily food poop and stool softener. I took the CVS stool softener until a year ago when I realized that, after a reduction of my constipation from the fiber, it was getting worse again. It was then that it became clear that my constipation was due to the stool softener.

Since then and after having taken over 1,000 stool softener capsules which had stored up in my body, I’ve nearly cleared it all out. I used various exercises, 3 suppositories daily and a healthy diet in the process. The stool softener is heavy and sticky, making it hard to poop out. Today I have a relatively small amount in my body, but find it very hard to clear out. It gets into my sinus cavities, causing dehydration. I can poop out small quantities of the stool softener. One serious side effect is my weight loss from keeping my digestive tract clear to allow the stool softener to ooze down. The best food for digesting food is kale, especially the stalk.

I’m close to getting the last of the stool softener out, but am more debilitated than ever in doing so. Is there anything that will help me to clear out the last of the stool softener?

Constipation is a very common symptom of Parkinsons disease. CVS =docusate is one of a family of drugs designed to increase the water content of your bowel motions to mitigate constipation and make motions easier to pass- an individual taking it at the recomended dose will not “accumuate” it in their body. Most prescribed drugs in the UK are accompanied by patient information leaflets on dosage regimes,side effects active ingredients etc. Your friend needs more medical advice/reassurance-other stool softeners are available which may be more effective.
ps they all benefit from an increase in water intake

Hello,

When listening to neurologist when they talk about constipation the first thing they ask are you drinking enough fluid 2 litres?

have had the same advice: 2 litres a day. Works wonders!

Thanks for the responses from everyone. I’ll pass them on to my friend and he or I will post any follow up replies.

Thanks for your reply. I suggested that my friend post a reply but he was not feeling well enough to do so. However, following is his reply to me:

Thanks for setting me up in the forum. The responses are not fully applicable to my condition. I’ve drank hot water and burned my tongue in the process, so that’s out. Two liters of water would work great if there’s no stool softener complicating the process. In my situation, lots of water soaks the stool softener to the point of forcing some of it out of my body. As the stool softener soaks, the pain increases until release. Once the release happens, there’s also a release of pain and a return of comfort in my body. Then the cycle starts all over again. A year ago, I had a release once or twice a day, which is why I took 3 suppositories a day. Now it takes 3 or 4 days between releases, despite all my efforts to push the softener out. That’s the result of having so little softener left in my body.

I know that everybody here suggested about 2 litres of water a day and said nothing about any of it needing to be hot. I’m not clear from my friend’s reply whether he is able to do the 2 liters per day so I’ll have to check with him. Also, I have seen it mentioned in several places that one should not take stool softeners or laxatives for more than a week straight, at least not without the direction of a doctor. Is that right? Thanks.