Outcomes Following Constipation Treatments Between Parkinson’s Disease and Non-Parkinson’s Disease Patients Evaluated by the Constipation Scoring System

Abstract

Objectives: The Constipation Scoring System (CSS) is a validated tool for assessing constipation severity and has been previously applied in Parkinson’s disease (PD) populations. However, comparative data on post-treatment CSS outcomes between individuals with and without PD remain lacking. This study aimed to compare post-treatment constipation severity between PD and non-PD patients in real-world clinical settings, with particular focus on neurology and gastroenterology outpatient clinics. Methods: This retrospective chart review included 67 patients with PD from a neurology clinic and 50 non-PD patients with constipation from a gastroenterology clinic. Baseline characteristics were retrieved from electronic medical records. Follow-up assessments were conducted through direct or telephone interviews to evaluate constipation severity using the CSS. Additional data were collected on patients’ self-reported intake of water, coffee, carbohydrates, and fiber, as well as exercise habits. Results: Post-treatment CSS scores did not differ significantly between groups (PD: 6.07 ± 3.57 vs. non-PD: 5.24 ± 2.84; p = 0.172), with most participants classified as having mild constipation. No significant differences were observed in daily water, coffee, or fiber intake, or in exercise habits. However, non-PD patients reported significantly higher carbohydrate intake compared to PD patients (p = 0.003). PD patients more frequently reported long-standing constipation symptoms (≥ 6 years) than non-PD patients (p < 0.001). Patterns of laxative use also differed: while sennosides were most commonly used in both groups, non-PD patients more frequently used lactulose and mucilin, whereas PD patients more commonly used Unison enemas (p = 0.020) and milk of magnesia (p = 0.070). Conclusion: Although constipation severity and treatment outcomes were comparable between PD and non-PD patients, PD patients more often experienced long-standing symptoms and demonstrated distinct patterns of laxative use. Prospective studies are warranted to evaluate standardized treatment protocols to better clarify treatment outcomes and inform clinical practice.