What to do when Parkinson’s Disease makes it difficult to “Go”
Updated: Mar 10
We’ll be talking about a less than polite topic in this article; however, it is one that affects over 80% of people with Parkinson’s Disease (PD). We will discuss Constipation. What it is, why it’s a problem, and how to manage it. Let's get started!
What is Constipation?
Constipation is a condition of slow-moving bowels. If you are having fewer than 3 bowel movements a week, or are straining to go, you are likely constipated. Ideally, you should be having at least one formed bowel movement a day.
Why is Constipation so common in PD?
Parkinson’s Disease is a disorder of the automatic processes of the body. This causes improper functioning of the autonomic nervous system which regulates smooth muscle activity. The muscles lining your entire GI tract are smooth muscles, can improper function of these can cause disruptions in peristalsis.
Peristalsis is the rhythmic contraction of smooth muscle that allows for food to move through the digestive tract. When this process is not working correctly, the movement of food/waste products in the intestinal tract becomes slower.
Also, many of the medications needed to treat Parkinson’s Disease can cause constipation as a side effect.
Finally, lifestyle factors that can cause constipation include:
2. Low fiber consumption
3. Decreased exercise
4. A change in routine or Stress
5. Consuming large quantities of dairy
6. Fighting the urge to have a BM until a more opportune time
Why is Constipation a problem?
You probably know, the timing of your medication cycle is very important to managing your PD symptoms. Did you know that the beneficial compounds in the pills you take are absorbed through your intestine into the bloodstream before they become active?
As your bowels move more slowly or become backed up due to constipation, the pills’ effectiveness decreases, and you may not receive the full benefit of the dose at the right time.
Other concerns with constipation include bloating, feeling uneasy and a desire to avoid exercise. With prolonged constipation, hemorrhoids or even bowel obstruction can occur. In bad cases, bowel obstruction can result in hospitalization.
Okay, so how do I prevent Constipation?
For a Happy Gut, here's a few helpful tips:
Consume enough fiber. The American Heart Association recommends 25 grams of Fiber daily. Fiber helps to hold water and bulk up the stool making it much easier to pass. The best way to eat enough fiber is by eating a variety of fruits, vegetables, legumes (like beans), and whole grain bread or cereal. You can also add prune juice, dried fruits, or bran to your diet to achieve your fiber needs. You’ll probably have some gas as you increase your fiber consumption, but this will improve with time.
Drink 6-8 cups of water and other fluids a day. Try drinking a tall glass of water with your medication doses, this will help flush the medication to the intestines where it can be absorbed, and if you do this with each dose, you’ll easily be able to achieve this goal.
Perform Vigorous exercise daily. Not only will this help your gut, but it will help you stay healthy and can slow the progression of PD symptoms.
Use the bathroom when you feel the urge.
What if I’m already constipated?
Along with the prevention techniques listed above, here are some other things you can do to help move things along.
1. Abdominal Massage: Take 10 minutes and give your belly a massage. With small circular movements starting down by your right hipbone, move upward toward your ribs, across to the left side, and down to your left hip bone. Research has shown this may stimulate peristalsis and lower the pain and discomfort that often occur with constipation.
2. Get a Squatty Potty! This 7-inch stepstool tucks under your toilet before and after you go (allowing you to safely get your feet to the floor to stand up). But when you’re ready to go, you put your feet on the stepstool to put your body into a more natural position which lets gravity do the work, allowing you to strain less.
3. Listen to your body. When you feel the urge to have a bowel movement, honor this and go to the toilet. It may not always be at the same time, and you may not always be home, but resisting the urge can cause more stool to backup and become harder to pass later.
Want to learn more? Check out our References and Resources:
[Podcast Recording] Constipation and the Gut in Parkinson’s - Davis Phinney Foundation
Current Overview on Clinical Management of Chronic Constipation (nih.gov)
Abdominal massage for the alleviation of symptoms of constipation in people with Parkinson's: a randomised controlled pilot study - PubMed (nih.gov)