Understanding Constipation in Parkinson’s Disease: Tips and Solutions

A common problem for people with Parkinson’s is gut issues like Parkinson's constipation. People may struggle with Parkinson's disease and constipation due to low energy, low appetite and low hydration. This can cause an imbalance in the bowel movement and cause constipation. 

In some cases, the condition can cause poor bowel movements, weak abdominal muscles and low physical activities. The symptoms are often bloating, lack of appetite and discomfort. It is important to keep an eye on the diets and stay hydrated and it can be managed with ease with consistent efforts.

Understanding the Link between Constipation and Parkinson’s Disease

Parkinson’s as a condition affects the nervous system, slowing down movement, including digestion. There could be nerve dysfunction that causes the brain to communicate less with the gut, which makes bowel movements less frequent. Weaker muscles, reduced activity, and certain medications make Parkinson's constipation worse. 

With Parkinson’s comes certain changes to lifestyle, such as increased lethargy, fatigue and disinterested in food, which can change the relationship with food and healthy bowel movements.

Definition and Overview of Constipation in Parkinson’s Disease

Constipation means having fewer than three bowel movements a week or struggling to pass stool. In Parkinson’s, slow digestion and weak gut muscles make it harder to move waste through the intestines, increasing the severity of Parkinson's disease and constipation.

Prevalence of Constipation in Parkinson’s Patients

Constipation is a prevalent non-motor symptom experienced by many individuals with Parkinson’s disease. Studies show that many individuals experience it, sometimes even before movement symptoms start. The risk increases as Parkinson’s progresses, making Parkinson's constipation an ongoing issue that many individuals deal with regularly.

The Role of Gut-Brain Connection in Parkinson’s Disease

The gut and brain communicate through nerves and chemicals. In Parkinson’s, this connection weakens, slowing digestion and causing constipation early on.

How Parkinson’s Affects Gut Motility

Parkinson’s can reduce the functionality of the nerves that control the intestines, which can slow down movement (peristalsis). It can also reduce the function of the vagus nerve that connects the brain and gut. This can cause slow bowel movements, increasing bloating in the long run. In some cases constipation may become more frequent even before other symptoms begin to show.

Microbiome Changes in Parkinson’s Patients

Parkinson’s disease impacts the gut microbiome by decreasing beneficial bacteria while promoting the growth of harmful ones. Studies show lower levels of short-chain fatty acid-producing bacteria, which help gut health. Harmful bacteria may trigger inflammation and worsen symptoms by affecting dopamine regulation. These imbalances can contribute to constipation and overall disease progression.

Causes of Constipation in Parkinson's Disease

A major cause of constipation is the lack of neural functions over a period of time between the stomach and the brain. In some cases, medication and lifestyle can exacerbate the condition.

Neurological Factors

Parkinson’s affects the autonomic nervous system, which regulates digestion. This can slow bowel movements and make it more difficult to pass stool. The vagus nerve, which helps regulate gut function, weakens over time. In the long run, this leads to sluggish digestion, fewer bowel movements, and a higher chance of constipation.

Medication Side Effects

Some Parkinson’s medications, like dopamine agonists and anticholinergics, slow gut movement. They affect the muscles that push stool through the intestines, making digestion sluggish. Opioids and certain antidepressants prescribed for Parkinson’s symptoms can also cause constipation by reducing intestinal contractions and fluid absorption in the gut.

Lifestyle and Dietary Influences

Reduced physical activity slows digestion and weakens abdominal muscles. Low water intake makes stool dry and hard to pass. A diet low in fibre reduces bulk in the intestines, making bowel movements less frequent. Changes in eating habits and reduced appetite are some other reasons for constipation.

Symptoms and Complications of Constipation in Parkinson's Disease

Constipation is a common condition in people of all ages and factors like lifestyle, diet and stress impact the intensity of it. In the case of Parkinon’s, it is important to keep an eye out for it as it can cause additional stress and, in some cases, can mean poor muscle functions that need attention.

Common Symptoms

Parkinson's constipation is a common yet often overlooked issue that can significantly impact daily comfort and overall well-being. Some of the common symptoms are given below:-

• Fewer than three bowel movements per week
• Hard, dry stools that are difficult to pass
• Straining during bowel movements
• Feeling like the bowel isn’t fully empty
• Bloating and abdominal discomfort
• Increased gas and cramping
• Loss of appetite due to sluggish digestion

Potential Complications

If not managed properly, constipation in Parkinson’s disease can cause serious health issues and affect daily comfort. Some possible complications include:-

• Hemorrhoids from frequent straining
• Anal fissures due to hard stools
• Bowel obstruction in severe cases
• Increased discomfort and pain
• Worsening of Parkinson’s non-motor symptoms like fatigue and mood changes
• Reduced medication absorption, affecting symptom management
• Higher risk of urinary problems due to pressure on the bladder

Diagnostic Approaches to Constipation in Parkinson's Disease

Parkinson’s needs a comprehensive diagnosis, as there are no specific tests to confirm the condition. A combination of clinical evaluation and diagnostic tests can help understand the intensity and any underlying causes for it.

Clinical Evaluation

Doctors ask about bowel habits, stool consistency, and any discomfort. They check for bloating, pain, and signs of slow digestion. A physical exam may include checking the abdomen for firmness or swelling. They also review medications and diet to find possible causes of constipation in Parkinson’s individuals.

Diagnostic Tests

Since Parkinson's constipation can have multiple causes, diagnostic tests help identify underlying issues and guide effective treatment. Some of the diagnostics are given below:-

• Blood tests and stool tests can help understand if there is an underlying issue with the digestive system or if there is an infection. 
• A colonoscopy can help in checking the intestines for blockages or ulcers. 
• This can be followed with MRIs, CT scans or ultrasounds to understand the physical condition of the gut.

Management and Treatment Strategies for Constipation in Parkinson's Disease

Constipation in the case of Parkinson’s can be managed with medication, changes to diet and lifestyle changes.

Dietary Modifications

Adjusting your diet in small ways can greatly enhance your digestion and aid in preventing constipation, ensuring that your bowel movements remain regular.

• Eating more fibre from fruits, vegetables, and whole grains helps move stool through the gut.
• Drinking enough water softens stools and makes bowel movements easier.
• Cutting down on processed foods reduces constipation risk.
• Stick to a food regime that ensures you eat on time and consume a well-balanced diet.

Medications and Supplements

Certain medications and supplements can play a key role in managing constipation, but it's important to use them appropriately under medical guidance.

• Doctors may recommend stool softeners or fibre supplements to improve bowel movements.
• In severe cases, laxatives may be prescribed to ease constipation.
• Probiotics help increase gut bacteria and aid digestion.
• Certain Parkinson’s medications may need adjustments if they worsen constipation.
• Always check medication effects to manage digestion without causing other issues.

Physical Activity and Exercise

Incorporating regular physical activity into your routine can help prevent constipation by keeping your digestive system active and functioning smoothly. 

• Stay Active: Regular movement stimulates digestion and helps food pass through the intestines.
• Engage in Gentle Exercises: Walking, stretching, and core exercises support gut motility.
• Try Abdominal Massages: Gentle massages on the abdomen can encourage bowel movements.

Long-Term Impact of Constipation in Parkinson’s Disease

Constipation, when left untreated can complicate the daily life of individuals with Parkinson's as it can increase fatigue and restlessness and reduce nerve functions. It can also signify an underlying cause that would need immediate attention.

Effects on Digestive Health

If the constipation is recurring and stays for a longer period, it can make digestion sluggish and be very uncomfortable. If left untreated, it could reduce nerve function to the stomach, which can have a serious impact on gut health and other bodily functions.

Risk of Intestinal Complications

Chronic constipation increases the risk of hemorrhoids and anal fissures from frequent straining. In severe cases, stool can build up and cause a blockage. Slow digestion may lead to bacterial overgrowth, causing gas and discomfort.

Impact on Medication Absorption

Delayed digestion affects how Parkinson’s medications work. Slow stomach emptying can delay drug absorption, making symptom control unpredictable. Some medications may not work as expected if the gut isn’t processing them properly.

Constipation in Parkinson's Disease: Preventive Measures

Constipation can be managed in most cases with a routine and a healthy diet. Some other factors that can help are medication and lifestyle changes.

Lifestyle Recommendations

Adjustments like eating fibre-rich foods, drinking enough water, and staying active help keep digestion steady. Set a regular bathroom routine that can train the body for consistent bowel movements. Practice mindfulness, some level of physical activity that can help stimulate the gut and keep you healthy.

Monitoring and Regular Check-ups

Tracking bowel movements can help detect changes early. Keeping notes on diet, activity, and medications can reveal what affects digestion. Regular doctor visits can help prevent constipation from leading to more serious issues. Discuss the symptoms openly with the doctors, which makes it easy to adjust care and prevent complications before they get worse.

When to Seek Professional Help for Constipation in Parkinson’s Disease

Seek medical help if constipation lasts more than a few days, causes severe discomfort, or leads to bloating and nausea. When bowel movements stop completely or weight goes down without explanation, see a doctor as soon as possible. Straining, hard   stools, or blood in stools need attention.

Living with Parkinson's Disease and Constipation

Dealing with Parkinson’s constipation can be frustrating, but simple lifestyle changes and proper care can make a big difference in managing symptoms effectively.

Coping Strategies

Some of the coping strategies to manage constipation are given below:-

• Stay Hydrated: Drink enough water daily to keep stools soft and easier to pass.
• Eat More Fibre: Include fruits, vegetables, and whole grains to support digestion.
• Stay Active: Walking and stretching help stimulate gut movement.
• Set a Routine: Try to use the bathroom at the same time each day.
• Manage Stress: Relaxation techniques like deep breathing can support gut function.

Support Resources

Support groups can help connect people facing similar challenges, offering advice and shared experiences. Dietitians and therapists can help create personalised treatment plans or routines that work best for you in managing digestive issues. Online forums provide information, and community support and anonymity can help reduce social anxiety or fear.

Physiotattva: Supporting Better Digestive Health in Parkinson’s Disease

At Cadabam’s Physiotattva, we understand the challenges of Parkinson’s, including digestive issues like constipation. With years of experience, our expert team offers personalised care to improve gut health through tailored therapy and lifestyle guidance. 

We focus on your unique needs, ensuring better digestion and overall well-being. Ready to take control of your health? Contact Physiotattva today and get expert support designed just for you!

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery. 

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.

FAQs

What deficiency causes constipation in Parkinson’s Disease?

Low dopamine levels slow gut movement, making digestion sluggish. Deficiencies in fibre, water, and magnesium also contribute to constipation. Reduced gut bacteria diversity in Parkinson’s individuals can further disrupt digestion, leading to irregular bowel movements and discomfort.

What is the root cause of constipation in Parkinson’s Disease?

Parkinson’s affects the autonomic nervous system, slowing bowel movements. The brain struggles to send signals to the intestines, weakening gut muscles. Medication side effects, reduced physical activity, and dietary changes make digestion even slower, leading to constipation over time.

What are the worst foods for constipation?

Processed foods, low-fibre diets, red meat, dairy, and fried foods slow digestion. Excess caffeine or alcohol dehydrates the body, making stool harder. White bread, rice, and sugary snacks lack fibre, worsening constipation by reducing bulk and slowing bowel movements.

How do you stop severe constipation?

Drinking more water, eating fibre-rich foods, and staying active help digestion. Establishing a bathroom routine supports regularity. Abdominal massage and warm fluids can stimulate movement. If constipation persists, doctors may recommend stool softeners or mild laxatives to ease discomfort.