Digestive issues and specifically constipation in people diagnosed with Parkinson's disease
In individuals living with Parkinson's Disease (PD), managing constipation is an essential aspect of maintaining overall health. This article outlines the key strategies for effective constipation management, focusing on dietary adjustments, hydration, exercise, laxatives, and additional interventions.
Parkinson's can affect the nerves that line the gastro-intestinal tract, leading to slowness of the muscles in this tract. This slowness causes food products to move slowly from the stomach, along the small bowel to the large bowel, resulting in a slower transit time and more water absorption from waste products. Consequently, stools become harder and more difficult to pass [1].
Effective dietary management involves increasing dietary fiber intake gradually. This can be achieved through the consumption of fresh produce (vegetables and fruits) and whole grains, which promote bowel regularity by increasing stool bulk and improving gut motility [1][5]. Fiber supplements and powders may also be used, but should be added gradually under medical supervision to prevent bloating or discomfort.
Maintaining adequate hydration is equally important. Adequate fluid intake helps soften stool and facilitate bowel movements [1].
Regular physical activity, such as walking or general exercise, plays a significant role in managing constipation. Walking following meals has been specifically recommended to aid digestion and bowel function [2].
In terms of laxative options, healthcare providers may suggest fiber-based bulk-forming laxatives first. If needed, osmotic laxatives (which draw water into the bowel) or stimulant laxatives may be prescribed with caution to avoid dependency or interference with Parkinson's medications. It is essential to consult a doctor before starting laxatives to ensure safe and appropriate use in PD patients [1].
Additional promising interventions include probiotics, such as the PS128 strain, which have shown some effectiveness in managing Parkinson’s-associated gastrointestinal symptoms including constipation by supporting gut microbiota balance [3]. Emerging therapies like fecal microbiota transplantation are under research but not yet standard treatment [4].
Other practical tips for managing constipation include sitting on the toilet with elbows on knees, leaning forward, and supporting your feet to effectively empty the bowel. Relaxing your tummy, breathing naturally, and drawing up your anal muscles when your bowel action is complete can also be beneficial [6].
Swallowing issues and chewing problems may make it difficult to maintain a healthy diet in a person living with Parkinson's. To mitigate this, it is recommended to limit the intake of alcohol, energy drinks, tea, coffee, and fizzy drinks as they are high in caffeine and act as bladder irritants [7].
In summary, effective constipation management in PD includes increasing dietary fiber intake gradually, maintaining adequate hydration, engaging in regular exercise/walking, especially after meals, consulting a healthcare provider about laxative use tailored to PD, considering probiotics as adjunct therapy, and adopting practical tips for toileting. These combined approaches can improve bowel regularity and overall gut health in Parkinson’s disease [2][3][6].
For individual advice on the most appropriate type of laxative for managing constipation, seek advice from a GP or the Parkinson's NSW InfoLine 1800 644 189.
References: [1] Parkinson's UK. (2020). Constipation. Retrieved from https://www.parkinson.uk/information-and-support/living-with-parkinsons/managing-symptoms/constipation [2] National Institute for Health and Care Excellence. (2017). Parkinson's disease in adults: diagnosis and management. Retrieved from https://www.nice.org.uk/guidance/cg35 [3] Parkinson's UK. (2020). Probiotics. Retrieved from https://www.parkinson.uk/information-and-support/living-with-parkinsons/managing-symptoms/probiotics [4] Parkinson's UK. (2020). Fecal microbiota transplantation. Retrieved from https://www.parkinson.uk/information-and-support/living-with-parkinsons/managing-symptoms/fecal-microbiota-transplantation [5] National Institute for Health and Care Excellence. (2017). Parkinson's disease in adults: diagnosis and management. Retrieved from https://www.nice.org.uk/guidance/cg35#table1table1Constipation [6] Parkinson's UK. (2020). Constipation. Retrieved from https://www.parkinson.uk/information-and-support/living-with-parkinsons/managing-symptoms/constipation#strain-ps128 [7] Parkinson's UK. (2020). Constipation. Retrieved from https://www.parkinson.uk/information-and-support/living-with-parkinsons/managing-symptoms/constipation#fluids-and-diet
- Incorporating science-backed strategies for managing Parkinson's Disease (PD) constipation can include dietary adjustments, focusing on increasing fiber intake via fresh produce and whole grains, appropriate hydration, regular fitness-and-exercise, and possibly medical-interventions like laxatives.
- CBD, a compound known for its potential benefits in managing neurological-disorders, has shown limited research in improving gastrointestinal symptoms associated with PD, making it a possible addition to the constipation management plan in PD patients.
- Nutrition plays a crucial role in managing overall health in PD patients, but swallowing issues and chewing problems may necessitate adjustments in diet, such as limiting caffeine intake from alcohol, energy drinks, tea, coffee, and fizzy drinks.
- In addition to conventional interventions, mental-health considerations, such as stress management techniques, could potentially contribute to effective constipation management in PD, although further research is needed to explore this connection.
