Managing Constipation and Its Risks in Parkinson's Disease: Is There a Role for Dietary Fiber?

Area of Science:

• Neuroscience
• Gastroenterology
• Nutritional Science

Background:

• Constipation is a common and quality-of-life-reducing consequence of Parkinson's disease (PD).
• PD-associated constipation links to gut dysbiosis and inflammatory metabolites, potentially worsening disease progression.
• Dietary interventions, including high-fiber diets and supplements, are considered for constipation management in PD.

Purpose of the Study:

• To evaluate the efficacy, safety, and feasibility of high-fiber diets and fiber supplements for managing constipation in people with Parkinson's disease.

Main Methods:

• This perspective reviews existing literature on fiber intake, gut microbiota, and constipation in Parkinson's disease.
• It analyzes the potential benefits and risks of various fiber sources and supplemental fiber for PD patients.

Main Results:

• Plant-based dietary patterns rich in diverse fibers may balance gut microbiota and metabolite production.
• Supplemental fiber may alleviate constipation but carries risks like appetite suppression and weight loss in neurodegeneration.
• Resistant fibers (bran, hull) may be most effective for stool bulking in PD-related slow transit and defecatory disorders.

Conclusions:

• High-fiber intake, particularly from diverse plant sources or specific resistant fibers, shows promise for PD constipation.
• Careful consideration of safety, including nutritional status, is crucial with fiber supplementation in PD.
• Further clinical trials are necessary to confirm the efficacy and optimal dosing of fiber interventions in Parkinson's disease.