Literature review: management of constipation in people with Parkinson's disease

Constipation is a common non-motor complaint among people diagnosed with Parkinson’s disease (PD) and it has a significant effect on quality of life. Numerous studies show that more than 50% of people in this patient group suffered from moderate to severe constipation. The causes of constipation for these people are multifactorial and include autonomic nervous dysfunction leading to slow transit constipation, defaecatory disorder, decreased mobility, reduced fluid intake, and medication side effects. This literature review assesses the available evidence for the effective management of constipation in people diagnosed with PD, including: conservative, pharmacological, invasive and non-invasive treatment, as well as surgical management. Most of the studies for managing constipation in people diagnosed with PD are small, open-label trials; however, we found two randomised controlled studies using pharmacological intervention that showed the effectiveness of the use of the osmotic laxative macrogol and one on the 5-HT4 receptor agonist tegaserod, the latter which is found to have significant cardiovascular side effects. Currently, the best evidence exists, from a small randomised control study, for the use of the iso-osmotic laxative, macrogol.