DEFINITION
- 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.
CONSTIPATION
- 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
- 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
- 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.
DROOLING
- 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.
DIFFICULTY WITH SWALLOWING
- 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.
