A patient with Parkinson's disease may have problems with:
(1) constipation
(2) straining to pass stool
(3) a feeling of incomplete evacuation of stool
Some patients may develop megacolon.
Factors contributing to the problem:
(1) delayed colonic transit due to dysfunction in the colonic myenteric plexus
(2) impaired coordination between anorectal muscles, including the anal sphincter
(3) pelvic floor dysfunction affecting the anorectal angle during defecation
(4) weak abdominal muscles
(5) constipating medications
Management may involve:
(1) use of laxative and/or stool softener
(2) adjusting medications that may be associated with constipation
(3) adjusting diet
(4) functional magnetic stimulation
(5) enemas
(6) prokinetic drugs
