Causes, Management, and When to Seek Help
Parkinson’s disease (PD) is well-known for its motor symptoms, such as tremors and muscle rigidity, but non-motor symptoms can be just as challenging. Among these, constipation is one of the most common and frustrating issues for patients with Parkinson’s. At Neurology Solutions Movement Disorders Center, we aim to provide comprehensive care that addresses both the motor and non-motor symptoms of Parkinson’s. This article will focus on understanding the causes of constipation in Parkinson’s and explore the most effective management options.
Why Constipation Happens in Parkinson’s Disease
Constipation is a frequent complication for those with Parkinson’s disease, affecting up to 80% of patients at some point during their illness. But why is this such a prevalent issue?
Constipation in Parkinson’s is primarily caused by autonomic dysfunction. The autonomic nervous system, which controls involuntary bodily functions like digestion, is impaired in Parkinson’s, slowing down gastrointestinal motility. This means that food moves more slowly through the digestive tract, making it difficult for the body to pass stools regularly.
The loss of dopamine-producing neurons in the brain also affects the gut. Dopamine, a neurotransmitter essential for movement, regulates digestive processes. The depletion of dopamine in Parkinson’s disrupts the coordination of muscles in the intestines, contributing to slowed gastric motility and, ultimately, constipation.
Several other factors can worsen constipation in Parkinson’s, including dehydration, inadequate fiber intake, and reduced physical activity.
Recognizing the Symptoms of Constipation
Constipation isn’t just about having fewer bowel movements—it can also manifest as hard, dry stools that are difficult to pass. Patients may experience bloating, discomfort, and a feeling of incomplete evacuation after using the bathroom. In more severe cases, a buildup of waste in the system can lead to complications such as abdominal pain, rectal bleeding, or even confusion.
Over-the-Counter Options for Managing Constipation
Fortunately, constipation can often be managed with various over-the-counter (OTC) treatments. Neurology Solutions recommends the following options:
- Stool Softeners: Medications like docusate sodium (Colace) help to soften stools, making them easier to pass without straining.
- Fiber Supplements: Increasing fiber intake through supplements like psyllium (Metamucil) or methylcellulose (Citrucel) can bulk up the stool and promote regular bowel movements.
- Laxatives: Options like senna and bisacodyl stimulate the intestines to contract, which helps move stool through the colon. Osmotic laxatives like MiraLAX work by drawing water into the intestines, softening the stool, and encouraging bowel movements.
- Magnesium Supplements: Magnesium hydroxide (Milk of Magnesia) and magnesium citrate are commonly used to treat constipation by increasing water in the intestines, making stools easier to pass.
- Suppositories and Enemas: For immediate relief, glycerin suppositories and Fleet enemas can help stimulate bowel movements and relieve discomfort quickly.
Prescription Medications for Constipation
If over-the-counter treatments aren’t effective, several prescription medications can help manage constipation:
- Lactulose: A synthetic sugar that increases water content in the stool. In the colon, bacteria ferment lactose into acids, which draw more water into the bowel, softening the stool and stimulating bowel movements.
- Prucalopride (Motegrity): This medication enhances bowel motility by stimulating serotonin receptors in the gut, helping to promote bowel movements.
- Linaclotide (Linzess) and Plecanatide (Trulance): These drugs increase fluid secretion in the intestines and accelerate intestinal transit, which helps to ease constipation.
- Lubiprostone (Amitiza): This medication increases fluid secretion in the intestines, making it easier to pass stool and alleviating chronic constipation.
Non-Medication Approaches to Relieving Constipation
Along with medication, certain lifestyle changes can help manage and prevent constipation:
- Increase Fluid Intake: Dehydration is one of the main contributors to constipation. Drinking plenty of water throughout the day can help keep the digestive system functioning correctly.
- Increase Dietary Fiber: Adding fiber-rich foods to your diet, such as fruits, vegetables, and whole grains, can improve digestion and promote regular bowel movements. If necessary, fiber supplements can also be used.
- Exercise: Physical activity stimulates bowel function, so engaging in regular exercise, even light activities like walking, can help improve symptoms of constipation.
- Probiotics: Certain probiotic strains, such as Bifidobacterium lactis and Lactobacillus reuteri, may improve gut health and reduce constipation by balancing gut bacteria.
When to Seek Medical Help
While most cases can be managed with the above treatments, there are times when medical attention is necessary. Suppose you have gone more than four to five days without a bowel movement and are experiencing symptoms such as abdominal pain, bloating, or rectal bleeding. In that case, it’s important to seek medical advice. Severe constipation can lead to bowel obstructions, which may require emergency intervention.
Additionally, if you notice signs of confusion or delirium, this could be a sign of more severe constipation, and immediate medical care may be needed. At Neurology Solutions, we understand that managing Parkinson’s disease goes beyond addressing motor symptoms. Constipation, while common, can have a profound impact on a patient’s comfort and quality of life. It can be managed effectively by recognizing the symptoms and employing a combination of over-the-counter treatments, prescription medications, and lifestyle changes.
If you or a loved one is struggling with constipation due to Parkinson’s, don’t hesitate to contact us for personalized advice and treatment options. Visit neurologysolutions.com to learn more about our comprehensive care services, or join our next support group meeting to connect with others facing similar challenges.