Everything You Should Know About Parkinson’s Disease and Constipation

Medically reviewed by Graham Rogers, MD on September 29, 2017Written by Carly Vandergriendt on September 29, 2017

Overview

Constipation is a common problem among people with Parkinson’s disease. It may appear years before other symptoms of Parkinson’s, and often appears before a diagnosis is made.

Signs and symptoms of constipation include:

  • having fewer than three bowel movements per week
  • passing hard, dry, or lumpy stools
  • having to push or strain to have a bowel movement
  • painful bowel movements
  • feeling as though your rectum is blocked
  • feeling as though your rectum is full, even after having a bowel movement

Constipation is among the most common gastrointestinal problems. According to a 2004 review in the American Journal of Gastroenterology, constipation affects between 12 to 19 percent of the population. It has many causes.

Read on to find out more about the connection between Parkinson’s disease and constipation.

Constipation and Parkinson’s

Parkinson’s disease is often associated with motor symptoms. Typical motor symptoms include:

  • tremors
  • stiffness
  • slow movements

Constipation is one of the most common non-motor symptoms of Parkinson’s disease. According to a review in the International Review of Neurobiology, up to 63 percent of people with Parkinson’s disease experience constipation. Constipation is a recognized risk factor in the development of Parkinson’s disease as well.

How does Parkinson’s disease affect the digestive system?

Parkinson’s disease has wide-ranging effects on the brain and the body, many of which researchers don’t fully understand. Several factors are believed to contribute to constipation among people with Parkinson’s.

Lack of dopamine

Dopamine, a neurotransmitter, is involved in controlling muscle movements. It sends signals that help your muscles to move.

People with Parkinson’s have a lack of dopamine. This makes it more difficult for the bowel muscles to push matter through the GI tract, leading to constipation.

Anorectal changes

Research suggests that Parkinson’s disease impacts the physiology and functioning of both the anus and rectum. In one study from 2012, researchers found that people who’d been recently diagnosed with Parkinson’s disease were more likely to have reduced anal sphincter pressure.

Poor muscle coordination

Parkinson’s disease weakens the muscles of the bowels and pelvic floor. That means that those muscles may be unable to contract, or they might relax instead of contracting. Either of those malfunctions can make it difficult for a bowel movement to occur.

Poor posture and inactivity

Parkinson’s can lead to a hunched or bent posture. It can also make staying active a challenge. Both of these factors can make it more difficult to have a bowel movement.

Difficulty eating and drinking

Adequate consumption of fluids and dietary fiber help prevent constipation. Parkinson’s disease impacts the muscles required to chew and swallow. This can discourage people with the condition from consuming enough fiber and fluids.

Medication

A number of medications used to treat Parkinson’s disease and related symptoms can cause constipation. These include anticholinergic medications, such as trihexyphenidyl (Artane) and benztropine mesylate (Cogentin), and certain antidepressants, such as fluoxetine (Prozac).

Other causes of constipation

Some other common causes of constipation include:

Treating Parkinson’s-related constipation

The following treatments can help to ease constipation in people with Parkinson’s.

Dietary and lifestyle changes

Simple diet and lifestyle changes may help restore normal bowel function. These include:

  • eating a well-balanced diet, including plenty of fiber
  • drinking six to eight 8-oz. glasses of fluids per day
  • drinking warm liquids, especially in the morning
  • establishing a daily routine
  • staying active

Bulk-forming laxatives

Bulk-forming laxatives such as psyllium (Metamucil), methylcellulose (Citrucel), and polycarbophil (FiberCon, Konsyl) can ease constipation. They work by absorbing liquid in the bowels to create a soft stool that’s easy to pass.

You can buy bulk-forming laxatives without a prescription. They’re generally safe, but you should speak to your doctor or pharmacist before taking them, as they can interfere with certain medications.

Stool softeners

Stool softeners, such as docusate sodium (Laxacin, Peri-Colace, Senohot-S) and docusate calcium are available over the counter. Similar to bulk-forming laxatives, they work by making stools softer and more liquid.

They can be used to treat short-term constipation, for example while you wait for dietary and lifestyle changes to take effect. They’re not considered an effective long-term treatment.

Probiotics

Some studies have found that probiotics can help ease constipation associated with Parkinson’s disease.

A study published in Neurobiology found that people with Parkinson’s who consumed fermented milk containing several probiotic strains and prebiotic fiber had more frequent, complete bowel movements.

Other treatments

Other treatments, such as laxatives, suppositories, and enemas, can have serious side effects. Your doctor can help guide you toward the most suitable treatment options when constipation persists.

When to seek help

You should contact a doctor if:

  • you experience constipation for the first time
  • you notice blood in your stool
  • you’ve lost weight without trying to
  • your bowel movements are accompanied by intense pain
  • you’ve been constipated for more than three weeks

How to prevent constipation

Simple lifestyle and diet changes can help to prevent constipation.

  • Drink an extra two to four 8-oz. glasses of fluids per day.
  • Add fiber to your diet.
  • Get regular exercise.
  • Have bowel movements when you feel the urge.

Takeaway

There are many possible causes of constipation, but it’s a common problem for people living with Parkinson’s disease. If you experience constipation, simple dietary and lifestyle changes may help to ease symptoms. Speak to your doctor about what you can do to manage your constipation.

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