Evaluating the Scope of Gastrointestinal Symptoms of Parkinson’s Disease: A Review of the Evidence
Gastrointestinal (GI) symptoms are among the most com- mon nonmotor manifestations of Parkinson’s disease (PD), and they have many important consequences for patients. Virtually all parts of the gastrointestinal tract can be affected, in some cases early in the disease course or even predating clinical PD. The main focus of this review is a discussion of the clinical presentation, evaluation, treat- ment options, pathology, and etiology of individual GI symptoms in humans. Dysphagia can predispose individuals to aspiration. Gastro- paresis can result in nausea, vomiting, and bloating and lead to erratic absorption of levodopa. Slow colonic transit can lead to constipation and anorectal dysfunction leads to difficulty evacuating the bowel. GI dysfunction in PD is often underreported and undertreated, and causes considerable morbidity for the patient. Therapeutic options are quite limited for the majority of these symptoms with very little guiding management.