Autonomic Abnormalities in Parkinson's Disease

Autonomic abnormalities occur when the nervous system does not work properly and can not regulate body functions. A variety of symptoms may occur including constipation, orthostatic hypotension, urinary frequency, drooling, or difficulty swallowing.

70% of Parkinson’s disease (PD) patients report constipation, with complaints of decreased frequency and increased bloating.
With PD, the gastrointestinal tract is lined with muscles that slow just like other muscles in the body.
The slower small intestine can cause bacterial overgrowth, resulting in bloating and fatigue, which are treated with antibiotics.
Read the website document on Constipation for more information.

Orthostatic hypotension occurs if the blood pressure drops when changing position.
Dizziness, lightheadedness, and fainting may occur when sitting up or standing.
Before feeling dizzy, some people complain of neck pain, difficulty getting thoughts together, or low energy.
Drugs to treat high blood pressure may have to be discontinued. Consult the provider before making any medicine changes.
Orthostatic hypotension can often be managed by staying well-hydrated, wearing compression socks, and drinking salty fluids like V8 juice.
Some people require medication to increase the blood pressure.

Urinary frequency is an autonomic abnormality, which may lead to incontinence (inability to hold the urine long enough).
Medications to treat urinary disturbances have side effects such as increased confusion and blood pressure changes, which may limit their use.
Urinary problems may be treated with Botox by a urologist.

The forward posture common in PD brings the saliva to the front of the mouth, causing drooling.
Keeping a lemon drop or Tic Tac in the mouth is a reminder to swallow.
Drooling may be treated with Botox.

Some people with PD have muscle slowness between the mouth and esophagus, causing difficulty with swallowing.
Delayed emptying of the stomach may also occur.
Swallowing problems and delayed emptying may contribute to levodopa not working well because of the delay in getting the medication to the small intestine where it is absorbed.
On/off cycles may be influenced by the delay in getting the medicine to the intestine.