Constipation in Parkinson's disease: objective assessment and response to psyllium

Area of Science:

• Gastroenterology
• Neurology

Background:

• Constipation is a common non-motor symptom in Parkinson's disease (PD).
• Reliability of patient-reported constipation history in PD requires validation.
• Understanding the impact of interventions like psyllium on PD-related constipation is crucial.

Purpose of the Study:

• To assess the accuracy of patient history in identifying constipation in Parkinson's disease (PD) patients.
• To evaluate the efficacy of psyllium in managing constipation and improving colorectal function in PD patients.

Main Methods:

• 12 patients with Parkinson's disease (PD) and constipation were enrolled.
• Patient-reported constipation history was compared with prospectively collected stool diaries.
• Colonic and anorectal function tests were performed.
• The effect of psyllium on stool frequency, weight, and bowel function was assessed.

Main Results:

• Constipation history was confirmed by stool diaries in 7 out of 12 PD patients.
• Confirmed constipated PD patients exhibited lower stool weights and increased straining.
• Colonic and anorectal function did not differ significantly between constipated and non-constipated PD patients.
• Psyllium administration led to increased stool frequency and weight in confirmed PD constipation cases, without altering colonic transit or anorectal function.

Conclusions:

• Prospective stool diaries are recommended for accurate constipation diagnosis in Parkinson's disease (PD).
• Psyllium demonstrates both subjective and objective benefits for constipation in PD patients.
• Further research into the mechanisms of PD-related constipation and optimal treatment strategies is warranted.