Written By: Renee Rouleau- B.S., PhD student, Jacobs School of Biomedical Sciences, University at Buffalo
Nutrition is this year’s theme for fighters and care-partners at Bridges for Parkinson’s.
This article focuses on how Parkinson’s Disease (PD) affects the gut, in terms of nutrient and medication absorption into the body, bowel obstruction and constipation, and how we can help manage those symptoms and feel better.
Most individuals have experienced how a bad gut can negatively impact one’s overall health, whether it’s eating bad food, a stomach virus, or a case of major gas causing uncomfortable abdominal bloating. In people living with PD, these issues can be chronic, and without proper care and diet, will affect your overall sense of well-being.
Let's take a closer look at these symptoms and identify solutions:
The symptom that you may not even feel at first, but one of the most important to address, is nutrient absorption into the gut. We know that eating veggies, protein, and carbohydrates is the key to a healthy diet. A mix of key vitamins and minerals, healthy fats, and proteins help build muscle while sugar aids in giving body energy. In a normal body, “gastric emptying”, or having the stomach empty contents into the small intestine, is an efficient and effective way for the body to process food and obtain all those nutrients when the food goes to the small intestine. The stomach really only acts as a balloon that inflates to hold the food long enough that it gets broken down by stomach acid and passed along for nutrient absorption in the small intestine. This process starts happening as soon as we eat and lasts a couple of hours (Goyal et al., 2019).
This process, however, can be delayed in PD because of muscle motility, even in involuntary muscles such as the stomach and intestines, and can be slowed up to 2 times as much. Thus, it takes much longer to digest food and can make you feel bloated or nauseous and occurs in roughly 45% of the population with PD as opposed to people of the same age group without PD (Pfeiffer et al., 2020). It can also lead to later issues of malnutrition due to the lack of nutrients that are able to be absorbed by the body, and more concerning, lack of medication absorption.
So how can we help to solve this issue? The first thing is making sure that it IS an issue. Although it’s important to consider diet in all of this, getting tests done for gastroparesis (delayed gastric emptying) can help you and your doctor know the degree of severity and how it can affect treatment. Research suggests that avoiding protein heavy diets is helpful for better absorption of medication, and that timing meals with your medication can also help absorption and lessen symptoms such as bloating and nausea (Pfeiffer et al., 2020).
*TIP: Take Parkinson’s medication 30 minutes before or one hour after a meal to ensure medication is completely absorbed.
Another symptom that frequently occurs is constipation and bowel obstruction, in which the body doesn’t have enough fiber or water to be able to break down indigestible food wastes. This can cause uncomfortable straining when trying to have a bowel movement. In more severe cases such as intestinal inflammation and bowel obstruction, the individual can experience severe pain, nausea and vomiting, or being totally unable to pass stool and ultimately lead to needing emergency care. Constipation is a non-motor symptom that can potentially start years before a formal Parkinson’s diagnosis and upwards of 50% of patients reported suffering from this symptom (Mukherjee et al., 2016)!
*TIP: Drink a full glass of water (8oz) when you take your medication. Did you know that your medication will sit in your stomach and never dissolve is you do not drink enough water?
Now, what are some additional options to help GI issues? One over the counter way that people tend to take on the short term could be laxatives, but this should also not be considered a long-term solution. Overuse of laxatives can cause other complications such as laxative addiction, flaccid rectal muscles. Research suggests that more fluid intake and a fiber rich diet not only helps constipation, but can also aid in gastric emptying (Mukherjee et al., 2016).
There are other medications such as lubiprostone which can help in more severe or chronic cases, but make sure to talk to your doctor first!
Although these symptoms can be painful and frustrating, they can also be manageable when properly diagnosed and reported. Our goal here is to raise awareness before anything becomes an issue! Hopefully we’ve shown you why it’s important to take care of your gut and that diet is as important as medication and exercise when it comes to managing PD. Stay tuned for our next conversation!
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