Data for this review were identified from my personal files, textbooks, and from PubMed searches with the terms “gastrointestinal dysfunction”, “weight loss”, “dysphagia”, “gastroparesis”, “gastric emptying”, “small intestine”, “colon”, and “anorectal” coupled with the term “Parkinson's disease”. Articles written in English were primarily and preferentially used, although a few articles in other languages were also included when an English abstract was present.
ReviewGastrointestinal dysfunction in Parkinson's disease
Section snippets
Basic mechanisms
Control of gastrointestinal function is complex and involves components of the central, autonomic, and enteric nervous systems. Cortical localisation for some parts of gastrointestinal function, including hunger, vomiting, swallowing, salivation, and defecation, has been identified.13, 14 Subcortical centres, including the basal ganglia, are thought to have some role in the modulation of gastrointestinal function, but exactly where and how is not completely clear. Information from cortical and
Weight loss
Although it is a common feature of PD, unintended weight loss has received little direct study. Abbott and colleagues26 documented weight loss in 52% of individuals with PD, with 22% losing over 12·8 kg. Beyer and colleagues reported a mean weight loss of 3·3 kg in 51 patients with PD, compared with a weight gain of about 1 kg in 49 control individuals.27 PD patients were four times more likely than controls to report a weight loss of more than 4·5 kg. Differences between men and women in
Conclusion
Gastrointestinal dysfunction in PD can manifest in many ways and pose many problems. Gastrointestinal features of PD occur along the whole tract and at any stage of the illness. Awareness of the various gastrointestinal manifestations of PD can facilitate prompt recognition and effective treatment of these potentially distressing symptoms.
Search strategy and selection criteria
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