Excess burden of constipation in Parkinson's disease: A pilot study

Abstract

An analysis was undertaken of clinic-based questionnaires that asked people with Parkinson's disease and a control group of older people without a known neurological condition about their experiences of constipation. People with Parkinson's disease report higher constipation on a validated objective measure, the Rome criterion (59% vs. 20.9%); a behavioral indicator, laxative-taking (38.4% vs. 14.2%); and subjective self-report of being always or often concerned by it (33.4% vs. 6.1%). Many people with Parkinson's disease experience constipation problems but they may not bring these to the attention of their healthcare providers. More research is required to understand the causes and management options.

Correlates of constipation in people with Parkinson’s

“…It adversely affects quality of life [2], and incurs significant healthcare costs for laxatives and the treatment of complications. Constipation is a symptom of neurological disease [3,4] and studies show that 50% [5] to over 70% [6] of people with Parkinson's suffer from constipation; and the excess burden relative to age matched controls may be as high as 60% [7][8][9][10]. Laxatives are estimated to be taken by approaching 40% of people with Parkinson's [6,10].…”

“…Constipation is a symptom of neurological disease [3,4] and studies show that 50% [5] to over 70% [6] of people with Parkinson's suffer from constipation; and the excess burden relative to age matched controls may be as high as 60% [7][8][9][10]. Laxatives are estimated to be taken by approaching 40% of people with Parkinson's [6,10]. Constipation is one of several autonomic system failures associated with Parkinson's [7][8][9][11][12][13][14].…”

Mechanisms of α‐Synuclein Pathology and Treatment in the Enteric Nervous System

“…Increased colonic transit time and impaired gastric emptying are frequently found in PD patients [35,42]. The prevalence of constipation in PD is at least three times that of the general population, leading some researchersto suggest that constipation might be a universal feature of PD [47,48]. Bowel immotility can occur 20 years before diagnosis of PD or NCDLB, suggesting that it might be a prodromal symptom for both disorders [5,19,36,44,[49][50][51][52].…”

“…Despite its prevalence in Lewy Body patients [46,47] and debilitating impact on quality of life, gastric immotility is rarely a focus of treatment for patients with PD and NCDLB [4,34,36,39,[53][54][55][56]. When PD and NCDLB constipation is addressed, primary care physicians typically recommend conventional (often overthe-counter) treatments, despite data demonstrating that such treatments are ineffective with this population [54].…”

Donepezil for Lewy Body Constipation: A Six-Month Follow-up

“…Research was reviewed demonstrating that (a) constipation in Parkinson's disease (PD) and Neurocognitive Disorder with Lewy Bodies (NCDLB) is the consequence of Lewy pathology in the myenteric plexus [2][3][4][5][6][7][8]; (b) 95% of innervation in the myenteric plexus (which controls motility in the colon) is cholinergic [9]; (c) constipation is a frequent Lewy body symptom producing difficulties for both patients and providers of care [10,11]; and (d) for patients with neurocognitive disorders, conventional constipation treatments have proven ineffective [12].…”