Management of Constipation in PD
The management of constipation in PD can be challenging. Often, recommendations are empirical and patients are advised to simply increase fluid intake. Algorithms are often developed for ease of administration, cost, physician experience, or patient choice. As an example, this author has suggested Vaseline balls for constipation in difficult cases. The balls, approximately a quarter inch in size, consist of Vaseline rolled in powdered sugar and frozen, with 2 balls taken orally. Although there is no formal evidence related to this treatment, it is known to be effective in my experience.
Treatment should start with the least invasive options such as diet and lifestyle modifications. Current medications should also be reviewed. If there is a secondary contributing cause perhaps due to medication, then adjustments should be considered.