Parkinson’s Disease & Constipation
Parkinson’s disease is a common neurological disorder. Patients with PD present with motor symptoms like resting tremor, rigidity of limbs and gait abnormalities. Constipation is the most common non-motor symptom of PD. About 50-80% of PD patients suffer from constipation.
Constipation may precede motor symptoms of PD by 20 years and hence it is one of the prodromal symptoms in PD.
Constipation in PD is attributed to involvement of ANS – autonomic nervous system, which controls gut motility. Colonic transit time of faeces is prolonged in patients with PD. Also, rectal evacuation is impaired in this group of patients.
It is important to rule out other causes of constipation even in patients with PD. Red flag signs/symptoms such as bleeding per rectum, unintentional weight loss and severe abdominal pain may pretend sinister diagnosis including malignancy. In such cases, colonoscopy may be required to rule out cancer, inflammatory bowel disease, etc.
The basics of managing constipation in PD include:
– Good hydration (water intake > 2 litres/day)
– High fibre diet/Medical fibres
– Daily walking/Exercise
– Bulk forming laxatives/Stool softener use
– Use of probiotics
– specific drugs, e.g.,: Lubiprostone along with Dopaminergic Therapy of PD
It is important to address this distressing symptom and manage it well so that patients benefit from the reduction of psychological/physical distress.
