Constipation in Parkinson’s Disease

Constipation is one of the symptoms associated with Parkinson’s disease (PD), characterized by infrequent bowel movements, hard stool straining, and a feeling that one could not release the stool completely. With bowel movements becoming difficult or less frequent, some people have bowel movements three times a day while others may have only one to two times a week.

The ill-functioning of the autonomic nervous system is often reported in Parkinson’s. When this system does not work properly, the intestinal tract may operate slowly, causing constipation. At times, the symptom can be a side effect of certain medications such as Artane and Cogentin.

Constipation is common in 80% of Parkinson’s cases. Many patients encounter constipation before they notice most common Parkinson’s symptoms like tremor or rigidity in muscles. Not drinking enough water, a diet low in fiber, lack of exercise, change in routine, eating large amounts of dairy products, stress, resisting the urge to have a bowel movement and consumption of antacid medicines (containing calcium or aluminum) can further intensify the problem.

Options to treat Constipation in Parkinson’s disease

Constipation can be corrected with dietary changes. A diet balanced with fiber, fluids and plants can help. A daily intake of 25-35 grams of fiber is suggested.  Along with many other aspects of the disease, physical activity may ease constipation, which is why exercising regularly is strongly recommended. At times, certain medications and laxatives help.

1. Healthy Diet

A healthy diet can be most helpful for people suffering from early-onset Parkinson’s. It can help Parkinson’s fighters reduce constipation and boost their immune system. Dieticians suggest increasing Fiber intake (through fruits, vegetables, legumes, and whole grain bread and cereal) and drinking the adequate amount of fluids (6 to 8 glasses) to prevent constipation. Avoiding Caffeine or Alcohol is also important as they act as diuretics and can aggravate constipation. Fiber-rich fruits and vegetables (bananas, apples, pears, guava, beans, peas and lentils) can also help improve digestive function hence prevent constipation.

2. Medication

Certain drugs for constipation can be used in Parkinson’s if other strategies fail. Clear liquids, syrups, tablets or capsules are prescribed that go directly into the gut (instead of entering the bloodstream) and prevent interactions with other Parkinson’s medications. Strong pain medicines such as Opioids, Antidepressants and Iron Pills are recommended if constipation is temporary, yet repetitive.

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Gastroenterologists also prescribe very mild stool softeners or laxatives that activate the bowel by chemical irritation. Since overuse of laxatives can aggravate the symptom, they should not be used more than two weeks without doctor’s advice.

3. Yoga

Yoga poses such as Empty Coat Sleeves, Knee-Down Twist or Marichyasana I (with slight modification) can help trigger digestive processes, aiding in alleviating constipation in Parkinson’s. Pranayama by involving abdominal breathing, intercostal breathing and clavicular (breathing help the practitioner relieve stress. Since stress further aggregates constipation in Parkinson’s, Kapal Bhati Pranayama can be particularly helpful.

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