Parkinson's Disease and Constipation - Dr Hiba Ismail

Parkinson’s disease is a progressive, degenerative neurological condition that affects the person’s ability to control their body movements. Symptoms of Parkinson’s disease 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). Degeneration of the nerve cells results in lower dopamine levels.

Many people who have Parkinson’s disease notice difficulties with constipation before they

notice motor symptoms such as tremor or stiffness. Recently, clinical and scientific attention has shifted to additional nonmotor symptoms that in the past have often passed unheeded. Of these symptoms, constipation is particularly relevant occurring in up to 66% of all PD-patients, thus showing a higher prevalence than within the general population.

Constipation often affects those with Parkinson's disease. It occurs when bowel movements become difficult or less frequent. The normal length of time between bowel movements ranges widely from person to person. Some people have bowel movements three times a day; others only one to two times a week. Going longer than three days without a bowel movement causes the stool to harden and become more difficult to pass.

Symptoms Of Constipation In Parkinson’s Disease

  1. Dry, hard bowel motions (poo) and difficulty in passing motions

  2. Fewer than three bowel motions a week (on average)

  3. Feeling the need to strain on the toilet

  4. Feeling that the bowel isn’t empty after passing motions.

What Causes Constipation in People With Parkinson's Disease?

In some people with Parkinson's disease, constipation may occur due to the improper functioning of the autonomic nervous system. The autonomic nervous system is responsible for regulating smooth muscle activity. If this system is not working properly, the intestinal tract may operate slowly, causing constipation.

  1. Lack of dopamine (a neurotransmitter) in the brain – impairs control of muscle movement throughout the body. Bowel muscles can become slow and rigid

  2. Uncoordinated bowel motions – the bowel muscles may be weak and unable to contract, or they may clench instead of relaxing when trying to pass a motion

  3. Also, medications used to treat Parkinson's disease (such as Artane and Cogentin) can cause constipation.

Other causes of constipation include:

  • Not drinking enough water

  • A diet low in fibre

  • Lack of exercise

  • Travel or another change in routine

  • Eating large amounts of dairy products

  • Stress Resisting the urge to have a bowel movement

  • Antacid medicines containing calcium or aluminum

  • Other medicines (especially strong pain medicines such as opioids, antidepressants, and iron pills)

  • Medical problems such as irritable bowel syndrome (IBS), diabetes, and colorectal cancer (rarely) Pregnancy

How Can I Avoid Getting Constipated?

  • Eat a well-balanced diet with plenty of fiber. Good sources of fiber are fruits, vegetables, legumes, and whole grain bread and cereal. Most of the fiber in fruits is found in the skins. Fruits with edible seeds, such as strawberries, have the most fiber. Eat bran cereal or add bran cereal to other foods, such as soup.

  • Drink 1½ to 2 quarts of water and other fluids a day. (Note: Milk can cause constipation in some people.) Liquids that contain caffeine, such as coffee and soft drinks, seem to have a dehydrating effect and may need to be avoided until your bowel habits return to normal.

  • Exercise regularly.

Complications Of Chronic Constipation In Parkinson’s Disease

Chronic constipation can cause further problems including:

  • Bowel Incontinence (Leakage Or Diarrhoea)

  • Urinary Incontinence (Caused By Pressure Against The Bladder)

  • Urinary Tract Infections (Utis)

  • Lethargy (Feeling Drowsy, Unenergetic Or Sluggish)

  • Nausea Abdominal Pain.

How Is Constipation In Parkinson’s Disease Treated In Ayurveda.

  • Drink two to four extra glasses of water a day

  • Try warm liquids, especially in the morning

  • Add fruits and vegetables to your diet

  • Eat prunes and bran cereal

  • Don’t increase dietary fibre too quickly or you’ll risk bloating and abdominal cramps. If discomfort occurs, cut back your fibre intake, increase your fluid intake, apply a hot water bottle to your abdomen

  • Dietary changes, including more fibre (for example, wholegrain foods such as cereals, brown rice, pasta and bread, pulses such as lentils and beans, and fruit and vegetables) rather than refined or highly processed foods, and water.

  • Moderate exercise

  • Good toilet habits

Ayurvedic drugs such as,

  • GandarvahastadiEranda thaila

  • Eradataila

  • sukumara Eranda

  • Gandarvahastadi Kashaya

  • Dasamoola hareetaki lehya

  • Triphala curna

  • Kapikachhu churna (mucuna pruriens) etc can be taken to relieve symptoms according to ayurvedic doctors advice.

Panchakarma procedures like,

  • Snehapana

  • virechana

  • vasti is also helpful according to patients condition

Yoga asanas are also proven to reduce the intensity of constipation such as,

  • Pranayama

  • Vajrasana

  • Bhujangasana

  • Halasana should be done.

PARKINSON’S DISEASE- An Ayurveda view - Dr. Hiba Ismail
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