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Shifting laxative dosing schedule to an earlier time improves refractory constipation in Parkinson's disease: A case series
Author(s) -
Neshige Shuichiro,
Neshige Ryuji
Publication year - 2018
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12225
Subject(s) - medicine , laxative , dosing , lubiprostone , constipation , bedtime , chronotherapy (sleep phase) , placebo , defecation , anesthesia , morning , chronic constipation , alternative medicine , pathology
Given the slow‐colonic transit, typical dosing schedule (bedtime administration) of laxative may be unreasonable for treating Parkinson's disease ( PD )‐related constipation, that is, to have morning defecations, bedtime administration might be too late for the drug to reach the large intestine during sleep (high colonic motility due to parasympathetic dominance). Shifting laxative dosing schedule to earlier times may help the drug to reach the large intestine during sleep. Here, we reported 21 PD patients with refractory constipation, whose bowel movements were significantly improved, and PD ‐related symptoms (such as wearing off and hallucinations) were substantially improved after the shift of laxatives dosing schedule to an earlier time. Because of the simplicity and effectiveness, this strategy might be widely used in treating PD ‐related constipation. This retrospective observational case series study was, however, limited in the uncontrolled study design, small sample size, and subjective data sources. A randomized, placebo‐controlled trial is warranted to confirm our results.