Early Symptoms

Constipation, a prevalent issue affecting 80-90% of people with Parkinson's, is a result of the impact on the autonomic nervous system. This system, responsible for regulating smooth muscle activity in the gut, experiences disruption, leading to a slowdown in the movement of food through the GI (digestive) tract. Understanding this cause can help manage the symptoms of constipation in Parkinson’s, which include infrequent and difficult bowel movements, straining during bowel movements, hard or pellet-like stools, and a feeling of incomplete evacuation.

Dysautonomia in Parkinson’s refers to the autonomic nervous system dysfunction, which controls involuntary bodily functions. Heart rate, blood pressure, digestion, constipation, urinary incontinence, excessive sweating, sexual dysfunction and temperature regulation may occur years before motor symptoms. Managing dysautonomia often involves a combination of lifestyle changes, medications, and other treatments.

GI issues arise because the autonomic nervous system, which controls automatic bodily functions, is compromised in Parkinson's, disrupting digestive processes. The most common problem is constipation. Other symptoms include gastroparesis, or delayed gastric emptying, which results in bloating, nausea, and early satiety; dysphagia, or difficulty swallowing; and sialorrhea, or excessive saliva production. Additionally, you may experience bloating and abdominal discomfort due to the slowed movement of food through the digestive tract. Managing these symptoms involves dietary adjustments, medications, and the empowering role of lifestyle changes, along with professional guidance, to improve quality of life.

Loss of smell, known as anosmia or a reduced sense of smell (hyposmia), is a common and early symptom of Parkinson's. Profoundly affecting your ability to detect and recognise odours, it may impact nutritional habits, enjoyment of food, and changes in appetite. It also poses safety risks, as you may struggle to detect hazards such as spoiled food or gas leaks. Psychosocially, scent is linked to memories and emotional connections. Managing changes to your sense of smell requires adaptive strategies to enhance safety, maintain nutrition, and address emotional and social implications.

Micrographia, a common early symptom of Parkinson’s, is characterised by abnormally small and cramped handwriting. You may struggle with everyday tasks that require writing, such as filling out forms or signing documents. Managing micrographia involves a combination of strategies, including handwriting training to improve motor skills and assistive devices like larger, weighted pens or digital tools. Regular practice and personalised management plans developed with your care team can help you cope with this challenging symptom.

Often unexplained anxiety, depression and apathy can occur years prior to motor symptoms presenting. Neurological changes in the brain due to Parkinson's can lead to personality shifts, withdrawal from previously enjoyed activities, and becoming more careless, rigid, belligerent or introverted. You can manage these symptoms with a care team, medications and relevant therapies.

REM Sleep Behaviour Disorder (RBD) is a sleep disorder characterised by the acting out of vivid, often unpleasant dreams with vocal sounds and/or complex motor behaviours during REM (rapid eye movement) sleep. Normally during REM sleep, your body's muscles are relaxed and inactive (atonia), but in RBD, this atonia is incomplete or absent, allowing you to physically act out your dreams.

Sleep disturbances are common in Parkinson's, affecting both sleep quality and quantity. Symptoms such as nighttime movement disorders (such as Rapid Eye Movement Behaviour Disorder (RBD) and Restless Legs Syndrome (RLS)), along with medication side effects, can contribute to difficulties falling asleep or staying asleep. These sleep issues impact overall well-being and daytime functioning for individuals living with Parkinson's disease. Good sleep hygiene is paramount to quality of life.

People with Parkinson's often don't talk about their eye problems, and doctors might not always notice them. The most common eye issues include seeing double, blurry vision, watery eyes, and seeing things that aren't there or visual hallucinations. Parkinson's can lead to various vision problems due to its impact on the brain and eye muscles.