Bowel incontinence

[pixie222]

I have suffered from constipation most of my life. Since being diagnosed with Parkinson's disease four years ago I approached the GP regarding constipation and started using prescribed laxatives.
About two years ago I started leaking small quantities of solid waste. I underwent manometry and have been found to have weakness in both the internal and external sphincters, as well as dissynergic defaecation.
I am having biofeedback training but find it hard to practise the proper technique for emptying my bowel because so much of my bowel leakage is passive. I have very numerous small bowel movements every day, mostly after breakfast but often after other meals as well. For the smaller bowel movements even when I am aware I need to go to the toilet I am not really able to exert any propulsion.
I understand that the inner sphincter is not subject to voluntary control and am worried that biofeedback is not going to be enough to resolve my problem.

[Dr Jamal Hayat]

It is important to give this time - as with any exercise or new regime it can take time and effort to start to see the benefits. Also important to let your biofeedback/pelvic floor specialist nurse know about your concerns - there may be more room to optimise the other measures to help the biofeedback be more effective - eg optimising dietary factors as well as the appropriate use of laxatives. There is asomedata that the use of a newer drug for constipation, lubiprostone can be beneficial in Parkinson's.