Continence management is one of the most confronting and difficult problems for people living with Parkinson’s and their carers, according to Victor McConvey, Parkinson’s Victoria clinical nurse consultant.
In the same way that reduced dopamine production in the brain causes Parkinson’s symptoms such as slowness, tremor and stiffness, reduced peripheral dopamine production in other parts of the body such as the gut causes it to slow down as well, he said.
In fact, constipation, which is further exacerbated by the person’s reduced mobility, is one of the earliest and most persistent symptoms of Parkinson’s.
“Constipation is the most common difficulty experienced in Parkinson’s. Problems with constipation are a frequent subject for calls to the Parkinson’s Information Line, and the second-most common reason someone with Parkinson’s will present to a hospital emergency department,” Mr McConvey said.
“Bladder and bowel function are both interrupted in Parkinson’s, but bladder difficulties are significantly exacerbated by constipation.
“Bladder problems are very common in Parkinson’s, but often overlooked or considered to be a ‘normal’ part of ageing,” he said
The most common bladder issues are urgency (having to urinate suddenly), frequency (having to urinate often) and nocturia (having to urinate overnight).
“Parkinson’s affects the neural pathway between the bladder and the brain, which can cause the brain to tell the bladder it needs emptying with little warning and often,” he said.
Nocturia results from urgency combined with lowered blood pressure and a person’s reduced mobility, both of which are common in Parkinson’s, causing fluid retention that the body excretes as urine overnight.
Nearly 70,000 people in Australia are living with Parkinson’s - a dramatic increase of 27 percent in just nine years (Living with Parkinson’s disease: An updated economic analysis 2014, Deloitte Access Economics).
Mr McConvey offered encouragement to people living with Parkinson’s and their carers. “With good management these difficulties can be overcome, and the impact of the symptoms can be effectively reduced.”
There is a range of management strategies and treatments that can alleviate symptoms, and a 12-minute video about the management of bladder and bowel difficulties for people with Parkinson’s has been produced by the Continence Foundation of Australia and Parkinson’s Australia. (To view, search “Youtube Parkinson’s and incontinence”)
Further help and advice is available from the organisations’ websites (continence.org.au and parkinsonsvic.org.au) and their freecall helplines - the National Continence Helpline (1800 33 00 66) and Parkinson’s Victoria’s Information Line (1800 644 189).