Constipation
is a complication of Parkinson’s disease. It can be managed with medical
treatment, diet and lifestyle changes.
Parkinson’s
disease is a progressive, degenerative neurological condition affecting the person’s
ability to control their body movements. Symptoms result from the degeneration
of nerve cells in the middle area of the brain that make and store dopamine (a
brain chemical necessary for smooth, controlled movements) thus lower dopamine
production.
The symptoms of constipation include:
•
Difficulty
in passing motions
•
Less
than 3 bowel motions a week
•
Feeling
the need to strain on the toilet
• Feeling
that the bowel isn’t empty after defecation
Why does
Parkinson disease cause constipation?
• Lack
of dopamine (a neurotransmitter) in the brain – impairs control of muscle
movement throughout the body including bowel muscles.
• Uncoordinated
bowel motions – the bowel muscles may be weaken and unable to contract.
• Eating
problems – dietary fiber is indigestible and prevents constipation. People who
have Parkinson’s disease sometimes find it difficult to chew or swallow so they
may avoid eating fibrous foods.
• Drinking
problem – swallowing difficulties may discourage a person with Parkinson’s
disease from drinking enough fluids.
•
Sedentary
lifestyle – lack of exercise slows the passage of food through intestines.
Parkinson’s disease reduces muscle control, so lack of exercise is common.
• Medications
– many different medications can cause constipation. Parkinson’s disease medications
may slow bowel movements or cause a decrease in appetite.
Various treatments to help to relieve constipation include:
- Dietary changes, including more fiber and drink more water. Choose wholegrain foods such as cereals, brown rice, lentils and beans, fruit and vegetables rather than refined or highly processed foods.
- Moderate exercise.
- Good toilet habits.
- Avoid medicines that contain substances, such as calcium, known to cause constipation.
- Laxatives.
- Treatment for any other medical problem that may be the underlying cause of constipation, such as haemorrhoids.
Dietary
fiber for constipation in Parkinson’s disease
• Soft
fruits. Mashed and pureed fruits are easier to eat. Make sure to include the
skin, where most of the fiber is found.
• Vegetable
soups
• Oat
bran or psyllium husks on your breakfast cereal or baked products such as
cakes. However, avoid bran if you have swallowing problems.
Fluids
for constipation in Parkinson’s disease
•
Six
to eight glasses (up to two litres) of fluid every day, especially water, is
best.
•
Limit
drinks that cause dehydration such as alcohol, tea and coffee.
Spread your drinks throughout the day.
Exercise
for constipation in Parkinson’s disease
• Aim
for at least 30 minutes of exercise every day. Walking and dancing are
recommended for people with Parkinson’s disease.
•
Remember
warming up and cooling down including stretching.
•
Only
exercise when other people are at home who can help if necessary.
Toilet habits
•
Go
to the toilet as soon as you feel the urge to go. Waiting too long can lead to
constipation.
•
Use
correct body posture on the toilet. Place your elbows on your knees and put
your feet on a footstool.
• Allow
yourself plenty of time. Avoid holding your breath and don’t strain when you
are on the toilet.
•
Use
a warm washcloth pressed against your anus or gently massage with one or two
fingers to help to relax the muscles.
Where
to get help
•
Your
doctor.
•
Your
neurologist.
People with constipation will be benefited from acupuncture treatment, new research
suggests. After eight weeks of electroacupuncture, acupuncture involving electrical
stimulation, study participants experienced significant symptom and quality-of-life
improvements, the study found. Electroacupuncture uses thin needles inserted
beneath the skin that are attached to a device that sends electric pulses into
the body. The medical
approach is to treat constipation by stimulating the sacral nerves and
increases small intestine and colon movements.
Yenny Vandalita, MD.
GP&Medical Acupuncturist
