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Characterization of swallowing and defecation in Parkinson's disease.
Am J Gastroenterol. 1994 Jan; 89(1):15-25.AJ

Abstract

Despite the high prevalence of Parkinson's disease, the pathophysiology of its gastrointestinal symptoms remains poorly understood.

OBJECTIVES

to evaluate swallowing and defecatory function in patients with Parkinson's disease and age- and sex-matched controls and to correlate objective findings with subjective symptoms.

METHODS

The following studies were performed on 13 patients with Parkinson's disease and seven controls: extrapyramidal function assessment, gastrointestinal symptom survey, videoesophagram, colon transit study, defecography, and anorectal manometry.

RESULTS

Abnormal salivation (frequency, %, control vs. Parkinson's disease: 14 vs. 77, p < 0.05), dysphagia (14 vs. 77, p < 0.05), constipation (14 vs. 31, p < 0.05), and defecatory dysfunction (29 vs. 77, p < 0.05) were more common among Parkinsonian patients. However, videoesophagographic abnormalities were equally common in both groups. Colon transit time was significantly prolonged in the Parkinson's disease group. Altered puborectalis function was noted on defecography in 31% of Parkinson's disease subjects, but in none of the controls (p < 0.05). Anorectal manometry identified several abnormalities in the Parkinson's disease group, which included decreased basal anal sphincter pressures, prominent phasic fluctuations on squeeze, and a hyper-contractile external sphincter response to the rectosphincteric reflex. Many patients exhibited both slow transit and manometric abnormalities, and symptoms were poor predictors of test results.

CONCLUSION

In this group of patients with mild to moderate Parkinson's disease, videoesophagographic abnormalities were not confined to the patients with Parkinson's disease. Studies of colonic and anorectal function, in contrast, identified a number of abnormalities. Therefore, colonic and anorectal dysfunction appears to be an early gastrointestinal manifestation of Parkinson's disease, and may represent the direct involvement of the gut by this disease process.

Authors+Show Affiliations

Department of Internal Medicine, University of Nebraska Medical Center, Omaha.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8273792

Citation

Edwards, L L., et al. "Characterization of Swallowing and Defecation in Parkinson's Disease." The American Journal of Gastroenterology, vol. 89, no. 1, 1994, pp. 15-25.
Edwards LL, Quigley EM, Harned RK, et al. Characterization of swallowing and defecation in Parkinson's disease. Am J Gastroenterol. 1994;89(1):15-25.
Edwards, L. L., Quigley, E. M., Harned, R. K., Hofman, R., & Pfeiffer, R. F. (1994). Characterization of swallowing and defecation in Parkinson's disease. The American Journal of Gastroenterology, 89(1), 15-25.
Edwards LL, et al. Characterization of Swallowing and Defecation in Parkinson's Disease. Am J Gastroenterol. 1994;89(1):15-25. PubMed PMID: 8273792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of swallowing and defecation in Parkinson's disease. AU - Edwards,L L, AU - Quigley,E M, AU - Harned,R K, AU - Hofman,R, AU - Pfeiffer,R F, PY - 1994/1/1/pubmed PY - 1994/1/1/medline PY - 1994/1/1/entrez SP - 15 EP - 25 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 89 IS - 1 N2 - UNLABELLED: Despite the high prevalence of Parkinson's disease, the pathophysiology of its gastrointestinal symptoms remains poorly understood. OBJECTIVES: to evaluate swallowing and defecatory function in patients with Parkinson's disease and age- and sex-matched controls and to correlate objective findings with subjective symptoms. METHODS: The following studies were performed on 13 patients with Parkinson's disease and seven controls: extrapyramidal function assessment, gastrointestinal symptom survey, videoesophagram, colon transit study, defecography, and anorectal manometry. RESULTS: Abnormal salivation (frequency, %, control vs. Parkinson's disease: 14 vs. 77, p < 0.05), dysphagia (14 vs. 77, p < 0.05), constipation (14 vs. 31, p < 0.05), and defecatory dysfunction (29 vs. 77, p < 0.05) were more common among Parkinsonian patients. However, videoesophagographic abnormalities were equally common in both groups. Colon transit time was significantly prolonged in the Parkinson's disease group. Altered puborectalis function was noted on defecography in 31% of Parkinson's disease subjects, but in none of the controls (p < 0.05). Anorectal manometry identified several abnormalities in the Parkinson's disease group, which included decreased basal anal sphincter pressures, prominent phasic fluctuations on squeeze, and a hyper-contractile external sphincter response to the rectosphincteric reflex. Many patients exhibited both slow transit and manometric abnormalities, and symptoms were poor predictors of test results. CONCLUSION: In this group of patients with mild to moderate Parkinson's disease, videoesophagographic abnormalities were not confined to the patients with Parkinson's disease. Studies of colonic and anorectal function, in contrast, identified a number of abnormalities. Therefore, colonic and anorectal dysfunction appears to be an early gastrointestinal manifestation of Parkinson's disease, and may represent the direct involvement of the gut by this disease process. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/8273792/Characterization_of_swallowing_and_defecation_in_Parkinson's_disease_ L2 - https://medlineplus.gov/bowelmovement.html DB - PRIME DP - Unbound Medicine ER -