Tuesday, February 27, 2024

Parkinson’s And Urinary Problems

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Excessive Saliva And Drooling In Parkinsons

How does Parkinson’s disease affect the urinary system?

Saliva is needed for the first stages of digestion, including chewing and swallowing. This watery substance contains enzymes that start to digest our food.

Many people with Parkinsons experience poor saliva control, which may result in excessive saliva and drooling, or alternatively, in a dry mouth and other eating problems.

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Related To My Parkinsons Disease

Waking up at night with the need to urinate, known as nocturia, can occur in nearly 60% of individuals with Parkinsons disease. This can result from either a small sized bladder or result from overactivity of the muscle lining the bladder wall called the detrusor , or it can occur from increased production of urine in the night . The assessment of nocturia may nececitate filling in a 3-day diary so that we can better understand the frequency of urination and volumes of urine voided. You may also need to undergo a test of bladder function called urodynamics. Having ankle swelling , medical conditions such as diabetes, heart failure or obstructive sleep apnoea, and alsosome types of medications such as diuretics can increase the chances for developing nocturia.

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Treatment For Over Active Bladder In Parkinsons

Overactive bladder affects up to 27% of men and 43% of women of the global population. Now, add a neurological condition and the problem becomes more challenging. First, there is a list of medications which make the problem worse, so should be avoided. Then, a thorough evaluation and physical exam. Treatment depends on the cause, but evaluating all medications and an adjustment of dopamine medication is often necessary. If you are still having problems, five further treatment options are included.

Eating the right amount of fibre and drinking enough fluids can help if you have constipation.

To get more fibre in your diet:

  • choose a breakfast cereal containing wheat, wheat bran or oats, such as Weetabix, porridge or bran flakes.
  • eat more vegetables, especially peas, beans and lentils.
  • eat more fruit fresh, stewed, tinned or dried. High fibre fruits include prunes or oranges.
  • drink plenty of fluids throughout the day to avoid dehydration. Lots of fluids are suitable, including water, fruit juice,
  • milk, tea and squashes. Cut out caffeine to avoid overstimulation of your bladder.

If you find it difficult chewing high-fibre food, you can get some types which dissolve in water. You can also get drinks which are high in fibre.

Try to increase how much fibre you get gradually to avoid bloating or flatulence .

A dietitian can give you further advice. Ask your GP, specialist or Parkinsons nurse for a referral.

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Common Prostate Drug May Slow Progression Of Parkinson Researchers Say

Terazosin, a drug used to treat enlarged prostate, may also be able to slow the progression of Parkinson disease.

Terazosin , a drug used to treat enlarged prostate, may also be able to slow the progression of Parkinson disease , according to a study published this week in the Journal of Clinical Investigation.

The finding is the result of a collaboration involving researchers in China and at the University of Iowa , combining observations from animal experiments with information from clinical databases regarding men taking the drug.

Lei Liu, PhD, at Capital Medical University in Beijing, China, found that terazosin could block cell death. Using toxin-induced and genetic PD models in mice, rats, flies, and induced pluripotent stem cells, the drug increased brain adenosine triphosphate levels and slowed or prevented neuron loss if it was given before the onset of cell death. In addition, the drug could slow or stop neurodegeneration, even if treatment was delayed until after neurodegeneration had started to develop. Lius team discovered that the cell-protective activity was due to terazosins ability to activate phosphoglycerate kinase 1 , an enzyme critical for cellular energy production.

Researchers then probed databases looking at patients who took terazosin and found slower disease progression, decreased PD-related complications, and a reduced frequency of PD diagnoses.

Patients using terazosin also had a reduced risk of a PD diagnosis, the researchers said.

Can You Drive With Parkinsons

11 Complications Of Parkinson

Yes. When you are diagnosed with Parkinson’s, you must tell the licensing agency straight away and talk to your GP, specialist or Parkinson’s nurse . Having the condition doesn’t necessarily mean that your licence will be affected, but you may need to have a medical or driving assessment.

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What Type Of Healthcare Professional Helps People With Speech Problems From Parkinsons Disease

If you have speech and voice problems, see a speech-language therapist. Your primary healthcare provider can help you find a therapist in your local area. Some speech-language pathologists have specialized training that focuses on training people with Parkinsons disease to amplify their voice. This is called the Lee Silverman Voice Treatment.

Speech-language therapists are specifically trained to diagnose and treat speech, language and swallowing disorders. If you have Parkinsons disease, a speech-language pathologist can help you:

  • Maintain as many communication skills as possible. Teach you techniques to conserve energy, including using nonverbal communication skills.
  • Introduce you to assistive devices and techniques to help improve your communication.
  • Recommend exercises to help you improve muscle strength and movements needed to improve your speech and communication options.

What Is Parkinsons Disease

Parkinsons disease is a progressive neurological disorder that affects how your muscles move. In the beginning stages, it can be easy to miss the early signs and symptoms of Parkinsons disease. The most common ones include:

  • Tremors, usually starting with the fingers or hand
  • A noticeable change in handwriting
  • Walking is slower, movement is stiffer
  • Stiff, rigid muscles

Also Check: What Causes Urinary Urgency And Frequency

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Swallowing And Saliva Management

This one-hour talk is in three parts. What a speech language pathologist is, how they can help someone with PD. Why you should be concerned about swallowing problems, some indications you may have a swallowing issue, what a swallowing assessment by an SLP might look like, and recommendations an SLP might make to improve swallowing. And, why you should be concerned about having either too much or too little saliva and how to manage either situation.

What Are The Late Stages Of Parkinson’s

Parkinson’s Disease and the Bladder

In late-stage Parkinson’s, symptoms are very severe, and often disabling. The later stages of Parkinson’s disease are characterized by severe tremors and shaking, stiffness in the trunk, limbs, and extremities, slow and difficult movement, a shuffling gait, and markedly stooped posture.

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Voiding Symptoms In Pd

The pooled prevalence of voiding symptoms was 24%. Prolongation was the most prevalent type of voiding symptoms in PD followed by the intermittency , urinary retention , dysuria , weak stream , and hesitancy . Some studies found that subclinical detrusor weakness during voiding may also occur in PD . These findings revealed that PD patients had both subclinical and clinical voiding symptoms. There was substantial heterogeneity in prevalence of voiding symptoms and its subtypes among studies. The source of heterogeneity could be the limited number of articles, diverse diagnostic tools and different characteristic of participants.

Urinary retention is the most disabling voiding symptoms and often used to differentiate Parkinson’s disease from multisystem atrophy. Previous studies have shown that the prevalence of urinary retention and large PVR was 43 and 14% in MSA and PVR volume 100 ml might be an effective indicator to differentiate PD from MSA . Unexplained voiding difficulties with PVR volume 100 ml was one of the core clinical features to identify the clinically established MSA . Furthermore, severe urinary retention in the first 5 year of disease is a red flag according to MDS clinical diagnostic criteria for PD.

Why Do Urgency And Frequency Occur

Bladder difficulties in Parkinsons are related to changes in the level of dopamine affecting the function of the bladder muscle. Parkinsons is also thought to affect the nerve pathway between the bladder and the part of the brain controlling bladder function. Some of the symptoms that affect bladder control are related to the level of dopamine in your body which will rise and fall depending on your medication level.

Other conditions such as weak pelvic floor muscles or an enlarged prostate will contribute to bladder symptoms. Constipation can also worsen bladder symptoms by putting pressure on the bladder.

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Prevalence Of Luts Subtypes In Pd

Storage symptoms

The pooled prevalence of storage symptoms was 59% .

Table 3. Prevalence of LUTS subtypes in PD.

Incontinence

The pooled prevalence of urinary incontinence was 30% . The pooled prevalence of urge incontinence was 32% .

Using urodynamic tests, the pooled prevalence of urinary incontinence was 21% , with significant heterogeneity . Using clinical scales, the pooled prevalence of urinary incontinence was 34% , with significant heterogeneity The pooled prevalence of urinary incontinence was 28% using questionnaires and 28% using definition in one study.

The pooled prevalence of urinary incontinence was 20% in PD with H& Y stage < 3, whereas 48% in PD with H& Y stage 3. The pooled prevalence of urinary incontinence was 20% in PD with age < 65 years, whereas 37% in PD with age 65 years .

OAB The pooled prevalence of OAB was 62% .

Urinary urgency

The pooled prevalence of urgency was 46% .

Urinary frequency

The pooled prevalence of frequency was 52% . The pooled prevalence of daytime frequency was 41% . The pooled prevalence of nighttime frequency was 53% .

Nocturia

The pooled prevalence of nocturia was 59% .

Pollakiuria

The pooled prevalence of pollakiuria was 65% .

Voiding symptoms

Retention

A total of 14 studies investigated the prevalence of retention in 1,991 patients with PD ranging from 8 to 76% and yielding a pooled prevalence of 27% . The pooled prevalence of PVR volume 100 ml was 4% .

Dysuria

The pooled prevalence of dysuria was 22% in PD .

What Causes A Urinary Tract Infection

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The main cause of UTIs, at any age, is usually bacteria. Escherichia coli is the primary cause, but other organisms can also cause a UTI.

In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes.

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Warning Disclaimer Use For Publication

WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.

DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.

If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.

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Cardiovascular Dysautonomia And Nocturia

An association is known to exist between orthostatic hypotension and nocturia, and nocturnal polyuria. In health, blood pressure is known to decrease at night, and this is often absent in patients with PD reporting autonomic failure. This may be mediated through inappropriate mineralocorticoid receptor activation. Consequent to this, pressure natriuresis occurs, resulting in increased urine output and the patient reports nocturia. OH and supine hypertension frequently coexist in PD, and older age, akinetic-rigid motor subtype, and pre-existing hypertension are independent risk factors for supine hypertension. Improvement of nocturia, however, has not been a consistent finding in studies evaluating treatments for supine hypertension,, , and therefore cardiovascular dysautonomia is likely to be only one of several mechanisms responsible for nocturia in PD.

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Parkinsons And Urinary Incontinence

Parkinsons causes problems with automatic bodily functions, such as breathing, heart rate, and urinary function. Urinary incontinence is much different than fecal incontinence and usually doesnt start to occur until the later stages of the disease. Urinary incontinence due to Parkinsons is a two-fold problem. The bladder has trouble holding urine in, but, at the same time, its difficult to control the release of urine, leading to some serious discomfort and emergency bathroom visits.

Urinary incontinence problems can come in many forms:

A person with Parkinsons may have to urinate very frequently, complicated by an increasingly difficult time with movement. Once they sit down, they may find it difficult to let go of the urine and void their bladder. While nearly 40% of Parkinsons patients may experience some level of urinary incontinence, only 15% of patients should develop a serious urinary condition.

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Incomplete Emptying Of The Bladder

Addressing Incontinence Concerns with Parkinsonâs Disease

Parkinsons disease may also make it harder for you to empty your bladder completely. This occurs less frequently than the need for frequent urination, but it still affects many people with Parkinsons.

Your muscles are the culprit of this problem. When you urinate, you relax certain muscles, and Parkinsons can make it difficult to relax those muscles. Sometimes, it takes a long time to relax enough, and people may not spend long enough in the bathroom to empty their bladder.

Unfortunately, medications dont always help fully with bladder emptying in Parkinsons disease patients, although the drug urocholine or other medications designed to treat urinary retention may help. different.

Some people with urinary retention have to use a catheter to empty their bladder. If this is the case for you, your healthcare provider can instruct you on how to use the catheter.

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Problems Caused By Limited Mobility

Some people with Parkinsons might soil their underwear. This is because mobility problems can make it difficult to wipe after using the toilet. If this is the case, it might help to use wet wipes, a bidet, or an adapted bottom wiper. An occupational therapist or the Disabled Living Foundation can offer further advice.

Bowel problems are common. But you should tell your GP if there are any changes in your bowel habits, particularly if you see blood in your stool. Some problems are difficult to avoid, but there are things you can do to make them less likely to happen.

How Can I Prevent Utis

Prevention is key to avoiding UTIs and the complications that may arise from them. Fortunately, there are several actions you can take right away to keep your urinary tract flowing correctly.

  • Drink plenty of water. Drinking water dilutes your urine and makes you urinate more often. This keeps bacteria moving steadily through your urinary tract before they can multiply and cause infection.Suzette Sutherland, MD, director of female urology at the University of Washington School of Medicine, says that one of the top reasons people develop urinary tract infections is simply not drinking enough fluids and keeping their urinary tract flushed.
  • Track your symptoms. Use our bladder worksheet to track your urinary symptoms and help you plan a conversation with your physician about any urinary concerns.
  • Visit a physical therapist. A physical therapist can teach you pelvic floor exercises, such as Kegels, that can help you manage incontinence or other urinary challenges. Regular pelvic floor exercises can help strengthen and retrain the muscles associated with urination and defecation.
  • Take preventative measures regarding sexual activity. Sexually active women can minimize their risk of developing UTIs by urinating soon after intercourse and avoiding birth control methods like diaphragms, unlubricated condoms, and spermicidal agents.
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    Parkinsons Disease And Voiding Dysfunction

    In this 54-minute webinar, urologist Dr. Sidney Radomski explains how voiding function is affected by Parkinsons disease in both men and women. He discusses how an enlarged prostate contributes to voiding problems and management options of voiding dysfunction for those with Parkinsons disease and MSA.

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    Evaluating And Treating Urinary Issues In Parkinsons Disease Multiple System Atrophy And The Other Atypical Parkinsonism Disorders

    Pin on Parkinson

    In this hour-long webinar, neuro-urologist Ekene Enemchukwu, MD focuses on urinary incontinence, overactive bladder, urinary retention, and other urinary issues in PD, MSA, and the atypical parkinsonism disorders. Following the presentation, moderator Candy Welch, Brain Support Networks MSA caregiver support group leader, asks Dr. Enemchukwu many questions submitted by webinar participants.

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    Does Water Help Parkinson’s

    Researchers have found that drinking adequate amount of water daily can lower the risk of symptoms of a progressive neurodegenerative disease like Parkinson’s. In Parkinson’s disease there is progressive damage to the brain leading to movement difficulties, tremors, masked face or lack of facial expressions etc.

    A New Toilet Or An Alternative

    If you have real difficulties getting to the toilet, it may be possible to get a grant to build a new one, perhaps downstairs. An occupational therapist can advise you on this.

    Not all homes are suitable for building new toilets, so a commode might be needed. A commode is a moveable toilet that doesnt use running water. It looks like a chair, with a container underneath that can be removed and cleaned after someone has used it. They can be very discreet.

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    Assessment Of Parkinsonism And Other Adverse Health Outcomes

    Parkinsonism was based on the presence of two or more cardinal signs of parkinsonism Trained nurse clinicians administered the mUPDRS. There were 26 items from the mUPDRS which assessed four parkinsonian signs . A sign was considered present if two or more of its respective items had at least a score of 1 indicating a mild abnormality. Parkinsonism was present if two or more of the four signs were present on clinical exam .

    Mortality: When an autopsy is obtained, date of death is known promptly. When no autopsy is obtained, we obtain information on date of death from an interview with a knowledgeable informant or searches of public databases as previously described.

    Disability was assessed annually via two self-report instruments. Basic activities of daily living were assessed using 6 items from the Katz scale . Mobility disability was assessed using the Rosow-Breslau scale, which assesses three walking performances .

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