Treatment of Multiple System Atrophy When Constipation Is Present

Constipation is a recognised complication in patients with multiple system atrophy (MSA) and requires a systematic management approach tailored to this population.

Clinical scenario

Constipation occurs commonly in patients with multiple system atrophy. Although it is not exclusive to MSA — it can also appear in Parkinson disease and other parkinsonian disorders — its presence in this context warrants structured, targeted intervention.

Treatment approach (partial overview)

Management centres on identifying and addressing modifiable contributing factors, alongside lifestyle adjustments and, where required, specific pharmacological agents targeting bowel function. The complete structured protocol — including the full sequence of interventions — is available via the link below…

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1212/cont.0000000000001598

Constipation and gastroparesis are common in patients with multiple system atrophy, although they are not specific because both can also occur in Parkinson disease and other parkinsonian disorders.

Constipation can be better controlled by removing aggravating factors (such as opioids or anticholinergics); increasing exercise; and taking sufficient fiber (such as vegetables and fruits), fermented milk products with probiotics, stool softeners, laxatives (such as polyethylene glycol), and prokinetic (such as lubiprostone and prucalopride) or prosecretory drugs (such as linaclotide).

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