Care Techniques
Let’s Start With a Story: A Silent Struggle
Mr. Ahmet is 67 years old and has spent most of his life teaching. He is an active and cheerful man who instilled both knowledge and affection in his students. However, a few years ago, he began to notice tremors, muscle stiffness, and a slowing of his movements. When he went to the doctor, he was diagnosed with Parkinson’s disease. Over time, alongside the difficulties in movement, he encountered another issue he didn’t expect: digestive problems. Constipation, heartburn, decreased appetite. Was this related to Parkinson’s? Mr. Ahmet and his family were not the only ones seeking this answer. Since then, hundreds, even thousands of people have embarked on a similar journey.
In this article, we will discuss, in simple and reassuring language, the digestive system problems commonly seen in Parkinson’s patients, how these issues affect the course of the disease, and—most importantly—the latest nutrition and lifestyle recommendations to improve quality of life, based on up-to-date scientific knowledge.
Parkinson’s and the Digestive System: Understanding the Unseen
Parkinson’s disease is a chronic and progressive neurological disorder caused by the gradual loss of dopamine-producing cells in the brain. Its typical symptoms include tremor, muscle rigidity, slowness of movement, and balance problems. But there is another very important aspect: gastrointestinal, or digestive system symptoms. These are often underestimated but can significantly impact a patient’s quality of life.
Constipation occurs in 60-80% of Parkinson’s patients (Source)
Difficulty swallowing, dry mouth, nausea, vomiting, heartburn, bloating are also common complaints.
Digestive issues can develop even years before the motor symptoms of the disease appear.
Why? Because Parkinson’s affects not only the cells in the brain but also the gastrointestinal nerve network (the enteric nervous system). This means that bowel, stomach, and esophageal movements slow down. The muscles and nerves of the gut, just like those in the arms or legs, are affected by the disease. And let’s not forget: the digestive system is so complex that it is often called the “second brain.”
Digestive System Issues and Parkinson’s: What Symptoms Do We See?
Constipation: Today, constipation may appear even 10-20 years before a Parkinson’s diagnosis. Slow bowel movements, reduced muscle tone, medications, and less physical activity all play a role.
Certain stomach issues: Delayed gastric emptying (gastroparesis), bloating, nausea, and loss of appetite can be significant problems.
Difficulty swallowing (dysphagia): Moving food from the mouth to the stomach may become challenging. The risk of choking increases, appetite decreases, and it can lead to weight loss.
Reflux, dry mouth, and burning sensations in the mouth: Reduced or, conversely, increased saliva production are also common.
Digestive System in Parkinson’s: Causes and Importance
Some studies focus on theories that Parkinson’s may start in the gut and spread to the brain (Source). Regardless of what starts first, one thing is clear: digestive issues can be just as bothersome as the motor symptoms of the disease. They lower quality of life and can reduce the effectiveness of Parkinson’s medications. For example, constipation and delayed gastric emptying slow the absorption of medications in the gut. This leads to more motor symptoms and a tougher struggle.
Maintaining Quality of Life: Nutrition and Lifestyle Recommendations
So, what can be done? Sometimes, small changes can make a big difference. Here are evidence-based recommendations that can help reduce digestive system problems in Parkinson’s and support a higher quality life:
1. Water, Water, Water!
Drinking at least 1.5-2 liters of water a day is the fundamental step in combating constipation. Water keeps stool soft and supports bowel movements.
The sensation of thirst decreases with age, so it’s important not to avoid water and to distribute consumption throughout the day.
2. Prioritize Fiber-rich Foods
Consuming 25-30 grams of fiber daily prevents constipation. Whole grain breads, oats, legumes, vegetables, and fruits are good sources.
Practical advice: Add a handful of dried apricots or prunes, yogurt, or oats to your breakfast.
Table: Some foods with high fiber content (per 100 g):
Food
Fiber (g)
Lentils
7.9
Apple (with skin)
2.4
Dried prunes
7.1
Buckwheat
10
3. Movement is Freedom
Walking, stretching, yoga—activity works all the muscles in the body and stimulates the intestines.
The level of physical activity should be adjusted to individual health status. 20-30 minutes of light exercise daily is recommended.
4. Don’t Skip Meals, Eat Regularly
Having a regular meal schedule regulates the rhythm of the stomach and intestines. Small, frequent, and low-fat meals are best.
Whenever possible, take a short walk after meals to stimulate the stomach and intestines.
5. Get Support from Probiotics
Yogurt, kefir, ayran, and fermented dairy products contain gut-friendly bacteria.
Recent studies show that probiotics reduce symptoms like constipation and bloating (Source).
For those who don’t like yogurt: homemade pickles, sauerkraut, kombucha are good alternatives.
6. Taking Medications Correctly: With or Without Food?
The main medication used in Parkinson’s, levodopa, is absorbed better on an empty stomach. Its absorption is impaired if taken with meals.
High-protein meals can reduce the effect of the medication. Therefore, it’s best to consume the main source of protein in the afternoon or evening meal.
7. Suggestions for Swallowing Difficulties
Do not consume solid and liquid foods together.
Eat in small bites and, if possible, sit upright.
If in doubt, consult a speech and swallowing therapist.
Small Touches in Lifestyle, Great Impact
Toilet Habits: Going to the bathroom at set times every day helps regulate bowel movements.
Stress Reduction: When anxiety levels are high, the bowels can become even more stubborn. Breathing exercises, relaxation techniques, and relaxation exercises help. Managing stress has a positive impact both on the digestive system and the general course of Parkinson’s.
Sleep Routine: Sufficient sleep is vital for body functions. Poor sleep is the enemy of both the brain and the gut.
Regular Doctor Visits: Timely consulting your doctor for digestive issues helps prevent more serious complications.
Life sometimes gets tough in unexpected ways. But a little touch, the right information, a look full of empathy—these can make life more bearable and hopeful. Remember, you are not alone; we are in this together.
Frequently Asked Questions
When should I see a doctor for constipation? – If constipation lasts more than 3 days, is accompanied by severe abdominal pain, nausea, vomiting, or loss of appetite, definitely consult a doctor.
Are dietary supplements necessary? – Generally, a balanced diet is sufficient. However, in specific cases like B12, vitamin D, or iron deficiency, supplements may be recommended by your doctor.
Which foods should be avoided? – Highly processed foods, simple sugars, packaged snacks, and very fatty meals can worsen digestive problems.
Is caffeine harmful? – As long as it’s not over-consumed, coffee or black tea can help stimulate the intestines. However, personal tolerance should be considered.
Living with Parkinson’s: Moving Forward with Hope
Living with Parkinson’s is a journey—even if its stops are tedious and challenging, with conscious choices, the right knowledge, and support, this journey can become lighter. No lifestyle change will completely eliminate all symptoms of the disease, but it can make your days much more comfortable and peaceful.
Remember, don’t let digestive problems make you feel embarrassed or hopeless. Knowing that these issues are part of Parkinson’s, both for patients and their loved ones, is the first step toward finding solutions. And often, even the simplest measures can make a significant difference in your life. Eat as balanced, varied, and enjoyable as you can, keep moving, don’t skip your doctor’s appointments. Most importantly: Always be kind to yourself.
References
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