Parkinson’s disease can affect many parts of the body, including the digestive system. Constipation is a common gastrointestinal symptom in people with Parkinson’s. Here is a quick overview of how Parkinson’s can affect bowel function:
How does Parkinson’s affect the bowels?
Up to 80% of people with Parkinson’s experience constipation and other bowel disturbances. This is often one of the earliest non-motor symptoms of the disease. Parkinson’s affects the autonomic nervous system which controls involuntary functions like digestion. This can lead to:
- Slowed motility of the bowels
- Incomplete emptying of the bowels
- Hardened stool
- Infrequent bowel movements
In addition, Parkinson’s medications like levodopa can exacerbate constipation as a side effect. The dopamine deficiency in Parkinson’s disease disrupts the normal functioning of the enteric nervous system that regulates bowel movements.
What bowel and digestive issues occur with Parkinson’s?
Some of the most common bowel and digestive problems associated with Parkinson’s disease include:
- Constipation – Having infrequent, difficult bowel movements. This affects 50-80% of Parkinson’s patients.
- Straining to pass stool – Having to push very hard to empty the bowels.
- Incomplete evacuation – Feeling like the bowels do not empty completely.
- Hard stool – Passing very firm, dry stools that are difficult to pass.
- Bloating – Abdominal distension from gas or stool buildup.
- Nausea – Feeling queasy or wanting to vomit.
Some people with Parkinson’s also experience diarrhea, urgency, or fecal incontinence. These symptoms are less common than constipation.
How does Parkinson’s medication affect bowel function?
Some Parkinson’s medications, especially levodopa, can worsen constipation and digestive issues. Possible effects include:
- Slowed gastric emptying
- Hardening of stools
- Worsening gut motility
- Nausea as a side effect
Other Parkinson’s medications like dopamine agonists, MAO-B inhibitors, and anticholinergics may also contribute to constipation. Consult with your doctor if you experience worsening bowel issues after starting a new Parkinson’s medication.
Tips for managing bowel problems with Parkinson’s
Strategies for dealing with Parkinson’s-related constipation and digestive issues include:
- Increasing exercise and physical activity
- Drinking more fluids
- Eating more fiber
- Establishing a bathroom routine
- Asking your doctor about stool softeners or laxatives
- Getting checked for bowel obstructions or other complications
- Practicing breathing exercises and relaxation techniques
Discuss any persistent bowel problems with your neurologist. Adjusting Parkinson’s medications may help in some cases. People with Parkinson’s may also benefit from seeing a gastroenterologist or colorectal specialist.
What tests help diagnose Parkinson’s bowel problems?
If you have severe or worsening bowel issues, your doctor may recommend tests to pinpoint the cause. These may include:
- Blood tests – To check for nutritional deficiencies, inflammation markers, or causes like thyroid disorders.
- Fecal occult blood test – Checks stool for hidden blood, which may indicate gastrointestinal bleeding.
- Abdominal x-ray – Visualizes obstructions, fecal impactions, or retained stool.
- Colonoscopy – Examines inside of the colon with a camera to check for polyps, cancer, or other issues.
- Gastric emptying study – Measures how quickly food empties from the stomach.
- Anorectal manometry – Evaluates anal sphincter pressures and rectal sensation.
In many cases, the doctor will start with a medical history review and physical exam. Additional testing provides more information when the cause of bowel dysfunction is unclear.
Can constipation be an early sign of Parkinson’s?
For some patients, chronic constipation or bowel motility issues can be one of the first subtle signs of Parkinson’s disease, occurring years before motor symptoms appear. Researchers believe Parkinson’s pathology in the enteric nervous system may cause digestive symptoms early on.
One study found the onset of constipation can precede the diagnosis of Parkinson’s by over a decade. Patients reported needing more straining and having very infrequent bowel movements.
However, constipation by itself is not diagnostic for Parkinson’s disease. It has many other potential causes. But unexplained, longstanding bowel issues should prompt evaluation for possible Parkinson’s in middle-aged and older adults.
The takeaway
Digestive problems like constipation, bloating, and nausea are very common in Parkinson’s disease due to its effects on the autonomic nervous system. Parkinson’s medications can also worsen bowel function as a side effect.
Managing bowel issues through diet, fluids, exercise, and laxatives can help improve quality of life. In some cases, medication adjustments may be needed. Consult your doctor if bowel problems persist or interfere with daily activities.
For some patients, chronic constipation is one of the earliest clues suggesting Parkinson’s pathology. While not definitive, long-standing bowel issues should prompt consideration of possible Parkinson’s disease.