Connecting Constipation and Parkinson's

Recent research indicates that chronic constipation can precede a diagnosis of Parkinson's disease by ten to fifteen years.

Constipation is defined as a condition in which there is difficulty emptying the bowels, usually associated with hardened feces. I have had many conversations over the years with PWP who struggle with this chronic condition. I've spoken with doctors about it too. But I didn't fully understand it until our company, The BioCollective, started our microbiome research project and began to gather stool samples from PWP. My team in the lab learned over time that they could actually tell that a person had Parkinson's from visual examination and processing of the samples for our research.

The stool samples from PWP have sections that often have the consistency of concrete. While other samples can easily be processed using a syringe to fill the sample tubes, PD samples require a caulking gun due to this challenging consistency. This led us to understand something that had not been published specifically in the research: there is clearly a problem with hydration and water homeostasis in Parkinson's.

What happens when waste sits in the digestive system and can't make its way out? Food enters our digestive system through the mouth where we break it down by chewing. As it moves down through the digestive system enzymes and stomach acid break down the food in to molecules we can use. When the system is slowed this partially broken down food sits in the digestive track and ferments. Bacteria can make both good and bad products of fermentation in your gut. You've probably experienced an episode of gas or bloating after eating something that disagreed with you. Certain bacteria have been identified in the Parkinson's gut that produce what are called bacterial protein toxins and products like hydrogen sulfide gas. As you can image from the term "toxins", it is not ideal to have a heavier burden of bacterial protein toxins just sitting in your digestive tract. The emerging field of microbiome research is beginning to expand on these early connectionss to search for causal bacteria and potential targets for therapies.

What causes constipation? Recent research has shown that gastrointestinal motility is more complicated than what we typically think of when we think of constipation. GI motility and the opening and closing of the valves along the path are controlled by the autonomic nervous system. Some potential contributors to constipation are stress, lack of exercise or a sedentary lifestyle, low fiber diets and dehydration. Another, less well known, cause of reduced motility is thiamine (B1) deficiency. 

What things might be helpful for intermittent or chronic constipation? Make sure the fluids you drink are hydrating rather than dehydrating. Drink water instead of tea or coffee and avoid sugary drinks. Eat more high fiber foods and add a soluble fiber supplement to your daily routine. If you add a fiber supplement, drink even more water! You can make things worse if you take fiber but don't get sufficient water. Magnesium and vitamin C can help with constipation.

Consider taking a thiamine supplement. Eat more fermented foods like kimchi and sauerkraut. Ayurvedic herbs such as Senna or Triphala are also used to help improve bowel regularity. Probiotics can also be helpful. The probiotic I made for my husband, John, has a side benefit of improving regularity.

Most neurologists don't focus much attention on chronic constipation. But this symptom was reported in our survey as one of the most disturbing on a daily basis for PWP. So try to "get moving" and see how much better you may feel.