Tuesday August 14 02:36 AM EDT
Constipation Raises Risk of Parkinson's
By Nicolle Charbonneau
HealthScoutNews Reporter

MONDAY, Aug. 13 (HealthScoutNews) -- Doctors know that
80 percent of patients diagnosed with Parkinson's Disease
suffer from constipation. Even James Parkinson noticed the link
between constipation and the disease that would bear his name.

Now a new study suggests that men with constipation have
at least twice the risk of developing Parkinson's.

The findings, reported in the Aug. 14 issue of Neurology,
offer the first evidence that constipation can predate this
neurological disorder by many years. Constipation, defined
as less than one bowel movement a day, affects roughly
5 percent of the general population.

Parkinson's disease (news - web sites) (PD) is a central
nervous system disorder that affects up to 1 million
Americans. While the cause of PD is not known, researchers
suspect that a genetic predisposition and an as-yet-unknown
environmental factor trigger the disease.

Robert Abbott, a professor of biostatistics and statistics
at the University of Virginia School of Medicine and the
director of biostatistics at the Pacific Health Research
Institute in Honolulu, led the study.

Using data from the Honolulu Heart Program, which
followed 6,790 men aged 51 to 74 on the island of Oahu
for 24 years, the researchers found 96 who developed PD.

After ruling out the effects of age, smoking, coffee
consumption, laxative use and diet, Abbott found that men
with constipation were 2.7 times more likely to develop PD
than men who averaged one bowel movement a day.

Compared with men who had two bowel movements a day,
constipated men were 4.1 times more likely to develop PD
and 4.5 times more likely than men who averaged more than
two bowel movements a day.

"The same processes that cause the motor symptoms of PD
may also affect the colon's functioning," says Abbott. "PD
does not just involve the brain but could also involve other
systems. … The fact that constipation can predate PD is
exciting to us because it could mean that the pathology of PD
might be recognizable before the usual motor [symptoms] that
we most often think about in the patient with PD. Unfortunately,
we can't say why the pathology in the gastrointestinal tract
might appear before the motor symptoms."

Abbott speculates that constipation could be a marker of
greater susceptibility to PD, but perhaps only if an unknown
environmental trigger is present. "The bottom line? You
might need both susceptibility and the environmental factor
to make PD risk a real problem."

The researchers suspect that with other signs of PD,
such as a family history and early motor disorders,
constipation could help identify individuals
at high risk for PD.

"Early identification could increase the capacity to enroll
subjects into neuroclinical trials that might lead to new
therapies or the identification of risk factors," says Abbott.
"Once these therapies and risk factors have been identified,
then early diagnosis might be important for the optimization
of intervention and prevention effects."

However, the clinical applications of the findings are not
yet clear. "Perhaps constipation in someone who is not
finding relief from medications, who also has a family
history of PD and emerging motor [symptoms], needs closer
follow-up from a neurologist, " says Abbott. "But again,
such recommendations are hard to make, particularly since
constipation becomes increasingly common in the elderly."

Dr. Robert Friedland, chief of neurogeriatrics at the Case
Western Reserve University in Cleveland, Ohio, calls the
findings "very impressive."

"It's possible that the neurodegeneration affects the
nervous system in the intestine," says Friedland. However,
he says, "It's also possible that this is related to some
environmental exposure which has two effects: One is that
you are at a higher risk of getting PD, and the other is that
you are constipated."

The researchers say the findings shouldn't alarm the average
person struggling with constipation. "Even in those with
constipation, the risk of PD low. In one year, PD would be
expected to occur in fewer than 20 per 10,000 people,"
says Abbott. "Although this rate is still much higher than
when constipation is absent, it is still a relatively uncommon
event."

"The important finding in our report is not to create concern
about constipation, but rather to help researchers understand
how PD progresses. Again, our data suggest that the
pathology in PD does not just involve the brain but could
also involve other systems."

In patients with the PD, an area of their brain called the
substantia nigra produces far too little of a neurotransmitter
called dopamine, which normally allows for smooth muscular
movement. The symptoms of the disease, which is somewhat
more common in men that in women, include progressive
rigidity, tremor, slowness of movement and difficulty walking.

While PD has no cure, patients can choose between several
drug and surgical therapies that target the symptoms of the
disorder.

What To Do
For more information on PD,
check the Parkinson's Disease Foundation,
Parkinson's disease: An Overview
http://www.pdf.org/aboutdisease/overview/index.html

the National Institute of Neurological Disorders and Stroke
NINDS Parkinson's Disease Information Page
http://www.ninds.nih.gov/health_and_medical/disorders/parkinsons_disease.htm

or the Michael J. Fox Foundation for Parkinson's Research.
http://www.michaeljfox.org/html/frameset.html

Meanwhile, the National Institute of Diabetes and Digestive
and Kidney Diseases has a primer on constipation.
http://www.niddk.nih.gov/health/digest/pubs/const/const.htm

SOURCE: YAHOO Daily News / HealthScoutNews
http://dailynews.yahoo.com/h/hsn/20010813/hl/constipation_raises_risk_of_parkinson_s_1.html

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