Naturopathic Treatment of Gastrointestinal Dysfunction in the Setting of Parkinson's Disease

Parkinson's disease is associated with multiple nonmotor symptoms including gastrointestinal (GI) distress, which affect patients' activities of daily living and are traditionally treated by pharmaceutical agents aimed at symptom control. In this case, a 73-y-old female presented with 3 wk of constipation and acid reflux after a recent diagnosis of Parkinson's disease and initiation of carbidopa-levodopa 6 mo prior. A contributing factor was anosmia leading to a vast dietary change. All other etiologies were excluded via clinical history and physical exam. Dietary intervention was initiated as the foundational treatment and included increased consumption of vegetables to 5 servings per day, increased dietary fiber to 30 g per day, increased protein consumption, decreased sugar consumption, and increased hydration. These dietary changes were accompanied by symptomatic relief of acid reflux through apple cider vinegar and deglycyrrhizinated licorice as well as probiotic and magnesium citrate initiation for constipation. The patient had complete resolution of constipation and 50% improvement in acid reflux after 5 d and complete resolution of all symptoms after 1 mo. GI complications associated with neurologic disorders such as Parkinson's disease may be managed via foundational dietary changes with natural symptom control with similar outcomes as pharmaceutical management but without lasting side effects.