Bowel problems can occur in anyone. But some problems, especially reduced bowel movement or constipation, are particularly common in people with Parkinson’s. This tends to be as a result of bradykinesia. This slowness, limited movement and muscle rigidity, which are visible symptoms of the disease, also effects the muscles we can’t see – including the bowel muscles - which in turn causes a reduction or slowness of bowel movements.
Poor bowel function may be exacerbated if a person finds it difficult to chew and swallow food, which is quite common with Parkinson’s. This may make it harder to eat a diet that is rich in fibre - for example fruit, vegetables and whole grains – which help form soft, bulky stools and aid bowel function.
Exercise may also play role in efficient bowel function. But people with Parkinson’s may find it difficult to remain active and this leads to reduced stimulation of the bowel and the intestines become sluggish.
Diarrhoea may occur as a side effect of certain Parkinson’s medications. If you experience diarrhoea it is important to talk to your doctor as they may be able to alter your medication regime in order to overcome this.
Constipation it is particularly common with this disease, possibly affecting up to 65% of those with it. Tremors and the subsequent fear of spillages can mean some people unintentionally reduce their fluid intake. But this can make stools hard and more difficult to pass. When stools remain unpassed for a long time, they become harder as the body absorbs more water from them. If stools build up in the rectum they can become impacted and block the rectum. They may also overflow as lumps of stool or watery mucus.
Also, if a person is anxious about their bowel movements, possibly because of the effect of certain medications, such as levodopa and anticholinergics, they might find it difficult to relax their bodies and muscles effectively to allow a stool to be passed, and constipation ensues. Such anxiety can also reduce the effectiveness of Parkinson’s medications. Parkinson’s itself can impair automatic relaxation of the pelvic floor which is necessary to straighten the last part of the intestine and allow the faeces to pass. This happens particularly during ‘off’ periods.
