CONSTIPATION IN PARKINSONS-DISEASE - OBJECTIVE ASSESSMENT AND RESPONSE TO PSYLLIUM

We evaluated the reliability of patient history and the effect of psyl lium on symptoms and colorectal function in 12 patients with Parkinson 's disease (PD) and constipation. In all but two, constipation anteced ed the development of parkinsonian symptoms. A comparison with prospec tively obtained stool diaries confirmed the patients' reported constip ation in 7 of the 12 patients. Those patients with confirmed constipat ion had lower stool weights and reported more straining at stool. Meas ures 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 confir m constipation in PD and that psyllium produces both subjective and ob jective improvements in constipation related to PD.