This is Dr.
John C. Morgan, neurologist at the Medical College of Georgia at Georgia
Regents University and Director of the National Parkinson’s Foundation Center
of Excellence at Georgia Regents Medical Center Credit: Phil Jones
Georgia Regents
Medical Center is among about a dozen centers nationally exploring the
potential of a new drug that may
offer relief to people with Parkinson’s who have failed standard approaches to
treating constipation.
“Constipation
in Parkinson’s is very prevalent,” said Dr. John C. Morgan, neurologist at the
Medical College of Georgia at Georgia Regents University and Director of the
National Parkinson’s Foundation Center of Excellence at Georgia Regents Medical
Center.
In fact, it’s
one of a handful of related problems, like an impaired sense of smell, that can
actually precede a Parkinson’s diagnosis by years then remain a factor as more
classic symptoms, such as tremors and stiffness, progress, Morgan said.
Additionally, constipation can be a side effect of the myriad of
medications patients may take for Parkinson’s.
The
Augusta-based center is enrolling about a half-dozen patients in the two-week
study offered through the Parkinson’s Study Group that will compare the
efficacy of this drug that activates ghrelin to placebo.
Early studies
of RM-131 in healthy individuals have shown it is safe and well-tolerated for
up to 14 days and that it improves the rate of stomach emptying and bowel
function, both important in avoiding constipation.
While
better-known symptoms of Parkinson’ are clear indicators that movement is
affected, a healthy gut also depends on movement to get food through the body,
said Morgan, a study Principal Investigator.
Parkinson’s
appears to result from the death of brain cells, also called nerve cells, which
produce dopamine, a chemical messenger important to movement. The gut actually
has as many nerve cells as the brain which is why the destruction also takes a
toll on a patient’s ability to defecate, Morgan said.
“The gut does
not move correctly all the way down – from the mouth to the anus, we think,”
Morgan said. “But it can also be a problem with the pelvic floor because when
we poop, we actually have to relax our muscles to get stool out and
patients with Parkinson’s may have difficulty
relaxing those pelvic floor muscles.”
Study
participants will keep a diary of their bowel activity and keep researchers
posted on any abdominal pain they may experience. The most common side effects
reported for RM-131 include dizziness, drowsiness and loose stools or diarrhea.
Morgan notes
that while the cause of nerve cell death in the brain and gastrointestinal
tract in Parkinson’s is not known, the brain shows signs of inflammation, which
can indicate an autoimmune response, as seen in diseases such as lupus,
arthritis and multiple sclerosis.
He always
encourages patients to eat well and stay as active
as possible and regularly asks about their bowel habits. However, even with due
diligence, a percentage of patients continue to struggle with constipation,
some to the point that they become impacted and require external stimulation,
such as an enema, to get relief. In addition to the obvious discomfort, failure
to defecate means the body holds onto toxins for extended periods, which can
actually result in mental confusion, Morgan said.
While
constipation is a transient state for most people, a study following thousands
of Japanese-American men for decades showed the incidence of Parkinson’s was
highest in those reporting less than one bowel movement daily and declined as
the number of regular bowel movements increased.
( I have not found any updates at this time Sept 2014)
http://www.npfsouthflorida.org/2014/new-constipation-treatment/
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