What is Parkinson’s Disease?
Parkinson’s disease (PD) is a movement disorder that occurs when the brain does not produce enough dopamine. Symptoms usually develop slowly and get worse over time. Typically, PD starts on one side of the body and over time affects both sides. As symptoms continue to develop, people living with PD may have trouble walking, talking, or doing simple tasks. There is no specific test to diagnose PD. A healthcare provider carefully reviews a person’s medical history and does an exam to check balance and coordination. This will then allow the healthcare provider to give a correct diagnosis.
Parkinson’s disease can negatively affect how muscles and nerves function at any point along the GI tract, causing changes in GI motility. These changes in GI motility can lead to other conditions including:
- Dysphagia – Dysphagia occurs when someone has difficulty swallowing. This can include feeling like solid or liquid foods are sticking, or not passing correctly through the esophagus. The esophagus is the muscular tube that connects the mouth and the stomach, allowing food to pass into the stomach.
- Gastroparesis (GP) – GP is a condition of slowed stomach emptying with no visible blockage. Symptoms often include abdominal pain, nausea, vomiting, early fullness, and losing weight without trying.
- Small intestinal bacterial overgrowth (SIBO) – SIBO is a disease that does not allow nutrients to be absorbed well by the body. This is caused by a high number of bacteria in the small intestine and is often the result of slowed movement through the GI tract. Symptoms of SIBO can include bloating, gas, abdominal pain, nausea, fatigue, a burning feeling in the chest, diarrhea, and constipation.
- Chronic constipation – This occurs when someone has one or more of the following symptoms:
- fewer than 3 bowel movements (BMs) a week,
- BMs that are hard, dry, or lumpy,
- BMs that are difficult or painful to pass, and/or
- a feeling that not all a BM has passed.
Changes in GI motility can have a large impact on the rest of the body. PD can specifically cause food and liquids to move through the body slower than normal. This can limit the body’s ability to properly take in and absorb medications. Most medications in pill form are created with a special coating or capsule that is designed to breakdown at a specific point along the GI tract. This allows medicine to be released and used by the body at the most effective part. When movement through the GI tract is slowed, medicine can be released from a pill before reaching the part of the body it was aimed for.
Symptoms of GI Motility Disorders
The following symptoms are common signs of a GI motility disorder. These symptoms can occur in healthy people and those with other conditions, such as Parkinson’s disease. For those living with PD, having any of these symptoms can be harmful to daily life and overall health.
- Losing weight without trying
- Abdominal pain – dull to sharp pain that occurs inside the belly, often in the stomach or intestines
- Nausea – a feeling of sickness and feeling the need to vomit
- Vomiting – bringing food back up from the stomach into the mouth
- Bloating – discomfort and feeling of an “inflated balloon” in the stomach
- Diarrhea – frequent, loose BMs
- Incontinence – accidentally leaking urine or BMs
- Constipation – having 3 or fewer BMs a week, and/or difficulty passing BMs
- Fatigue – feeling low energy, overly tired
Any of the possible conditions and symptoms that can occur with Parkinson’s disease can lead to a significant impact on daily living and a lessened quality of life for patients. Nearly all patients with PD are impacted by some degree of GI symptoms since PD can lead to symptoms in all areas of the GI tract (i.e., esophagus, stomach, small bowel, colon, and rectum). These symptoms must be evaluated and treated to ensure the best possible quality of life and overall disease management. It is important to fully discuss all symptoms with your healthcare provider.
Adapted from IFFGD Publication #401 Parkinson’s Disease and GI Motility By: Baharak Moshiree MD MSc, Mackenzie Jarvis PA-C, DMs, Atrium Health, Wake Forest, Digestive Health-Morehead Medical Plaza; Marissa Lombardi, International Foundation for Gastrointestinal Disorders