Parkinson’s disease (PD) affects a specific area of the brain that is responsible for movement. The disease causes nerve cells in this area to break down, decreasing the amount of dopamine in the brain. Dopamine is a chemical messenger that plays a role in various behavioral and physical functions including motivation, sleep, mood and movement. As PD progresses, there is less and less dopamine to go around, which can lead to symptoms like tremors, slowed movement, and rigid muscles. Furthermore PD is often accompanied by additional symptoms including bladder problems, constipation, sexual dysfunction and pain. This article will focus on the influence of constipation throughout the disease process.
Before being diagnosed, early screening for PD looks for changes to the autonomic system. The autonomic system is responsible for involuntary bodily functions such as regulating your heart, temperature, breath, and intestines. Three of the most common early autonomic changes include constipation, changes to sense of smell (known as olfactory dysfunction)and changes in sleep behavior. Between 70-80% of people diagnosed with PD will experience some type of autonomic change. Constipation is the most common change, with research showing that for men with less than 1 bowel movement (BM) per day, there is up to a 4.1 fold risk of developing PD when compared to men with greater than 2 BM/day. By no means does constipation definitely result in a diagnosis of Parkinson’s disease, but knowing this data allows clinicians and patients alike to better understand and manage bowel habits. Upon diagnosis, constipation continues to be a concern, especially since most medications to treat PD have constipation listed as a side effect. Additionally, changes like reduced physical activity, altered hunger signaling, loss of taste or smell, and slowed gastric emptying time can increase the risk of constipation.
Pelvic floor rehabilitation can be an excellent choice for conservative management in bowel habits and routine. Research suggests improvements in bowel emptying with changes to fiber intake, fluid consumption, abdominal massage, stretching and pelvic floor strengthening. Getting started can seem overwhelming, but appropriate instruction and expectations can be learned during visits with your pelvic floor provider.