Management of constipation in Parkinson's disease

Area of Science:

• Neurology
• Gastroenterology

Background:

• Constipation is a prevalent non-motor symptom in Parkinson's disease (PD).
• It frequently precedes motor symptoms by up to two decades.
• Constipation negatively affects daily living, productivity, and quality of life.

Purpose of the Study:

• To review the safety and efficacy of traditional and novel constipation management strategies in PD.
• To present a treatment algorithm for managing constipation in Parkinson's disease patients.

Main Methods:

• Review of existing literature on constipation management in PD.
• Discussion of pharmacological and non-pharmacological interventions.
• Development of a clinical treatment algorithm.

Main Results:

• Polyethylene glycol and lubiprostone are recommended first-line treatments for slow colonic transit constipation in PD.
• Management of defecatory dysfunction may involve medications like levodopa or apomorphine, botulinum toxin injections, or non-pharmacological therapies.
• Biofeedback and functional magnetic stimulation show potential but require further investigation.

Conclusions:

• Evidence-based guidelines support specific treatments for different types of constipation in PD.
• Further research is necessary to fully establish the efficacy of novel and non-pharmacological interventions.
• Optimizing constipation management is crucial for improving the quality of life for individuals with Parkinson's disease.