Constipation in parkinson's disease: Objective assessment and response to psyllium

Authors

  • Waseem Ashraf,

    1. Sections of Neurology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
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  • Ronald F. Pfeiffer,

    1. Sections of Neurology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
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  • Faye Park,

    1. Sections of Neurology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
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  • John Lof,

    1. Sections of Neurology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
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  • Dr. Eamonn M. M. Quigley

    Corresponding author
    1. Sections of Neurology and Gastroenterology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A.
    • University of Nebraska Medical Center, 600 S. 42nd Street, Omaha, Nebraska 68198–2000
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Abstract

We evaluated the reliability of patient history and the effect of psyllium on symptoms and colorectal function in 12 patients with Parkinson's disease (PD) and constipation. In all but two, constipation anteceded the development of parkinsonian symptoms. A comparison with prospectively obtained stool diaries confirmed the patients' reported constipation in 7 of the 12 patients. Those patients with confirmed constipation had lower stool weights and reported more straining at stool. Measures of colonic and anorectal function were similar in those who were truly constipated and those who were not. Among those PD subjects with confirmed constipation, psyllium increased stool frequency and weight but did not alter colonic transit or anorectal function. We conclude that prospectively obtained stool diaries should be employed to confirm constipation in PD and that psyllium produces both subjective and objective improvements in constipation related to PD.

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