Management of The Gastrointestinal Disturbances in Parkinson's Disease Patients

Abstract

The purpose of this review is ta evaluate currently available information regarding thefrequency, clinical features, and pathophysiology of gastrointestinal symptoms in patients with Parkinson's disease (PD). Gastointestinal (GI) motility disordersare frequent in patients with Parkinson's disease, manifesting mainly as dysphagia, disorders of gastric emptying and constipation . Although more extensive research is required ta fully caracterize the pathophysiology of the gastrointestinal symptoms in PD, much of the presently available data suggest that the primary PD process is themajor factor in the etiology of gut dysfunction in this patients population . This may be mediated by both central and peripheral mechanisms. The presence of Lewy bodies, the primary neuropathologic finding in the central nervous system in PD, in the myenteric plexus of both the esophagus and colon suggest that the PD process may alsa affect theenteric nervous system and contribute ta the development of esophageal dismotility and constipation through this peripheral mechanism. in the treatment of gastric motility disorders, domperidone, a peripheral dopamin antagonist, is the drug of choice far the upper GI tract. in the lower GI traet, conservative therapeutic options should be used inthe first instance.