February 2011
Wächter T, Mínguez-Castellanos A, Valldeoriola
F, Herzog J, Stoevelaar H
PURPOSE: To investigate
clinical, demographic and dietary factors associated with constipation
in a sample of community dwelling people with Parkinson's disease,
recruited through a specialist outpatient clinic. Partners/carers
provided a convenience control group.
SCOPE: Participants
completed a baseline questionnaire (background information, diet and
exercise, activities of daily living: mobility and manual dexterity,
health-related quality of life (SF-12), stool frequency and
characteristics, extent of concern due to constipation, laxative
taking), and a four-week stool diary. The Rome criterion was used to
determine constipation status. Multiple regression methods were used to
explore the correlates of constipation. Baseline data were provided by
121 people with Parkinson's, (54 controls), of whom 73% (25%) met the
Rome criterion. Prospective diary data from 106 people with Parkinson's
(43 controls) showed lower proportions: 35% (7%) meeting the Rome
criterion. Among all study subjects, i.e. Parkinson's patients and
controls taken together, the presence of constipation is predicted by
having Parkinson's disease (p = .003; odds ratio 4.80, 95% CI
1.64-14.04) and mobility score (p = .04; odds ratio 1.15, 95% CI
1.01-1.31), but not by dietary factors. Amongst people with Parkinson's
constipation is predicted by number of medications (p = .027). Laxative
taking masks constipation, and is significantly associated with wearing
protection against bowel incontinence (p = .009; odds ratio 4.80, 95%
CI: 1.48-15.52).
CONCLUSIONS: Constipation is disease-related, not a lifestyle factor. More research is needed on optimal management and laxative use.
