A focus on Rome III criteria for the assessment of constipation in Parkinson's disease

Barichella, Michela; Cereda, Emanuele; Cassani, E.; Frazzitta, Giuseppe; Pezzoli, Gianni

doi:10.1002/mds.26974

Cited by 6 publications

(4 citation statements)

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“…In this study, we selected ROME III criteria for constipation, which was developed and widely accepted by gastroenterologist [ 1 , 14 ]. According to the review by Knudsen et al [ 1 ] in 2017, there was lack of the summary of this assessment.…”

Section: Resultsmentioning

confidence: 99%

“…The pooled prevalence of subjective constipation in PD patients was between 40% and 50%, which was relatively lower than our result. However, Knudsen et al found that constipation in these studies was not diagnosed by the ROME III criteria which was widely accepted criteria for constipation [ 14 ]. The ROME III criteria for constipation was developed through international consensus and widely accepted in the gastroenterological community.…”

Section: Discussionmentioning

confidence: 99%

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A survey of subjective constipation in Parkinson’s disease patients in shanghai and literature review

et al. 2018

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BackgroundConstipation is one of the most frequent non-motor symptoms (NMS) in Parkinson’s disease (PD) and the prevalence of constipation in PD patients varies among different studies. We designed this study to survey the prevalence and clinical characteristics of subjective constipation and the appearance chronology between the emergence of constipation and onset of motor symptoms in PD patients from Shanghai, China.Methods268 PD patients were continuously recruited into this study. Parkinson’s related clinical information of the participants was collected. A spectrum of motor and nonmotor features was assessed with scales and questionnaires. Subjective constipation was defined by ROME III criteria.Results54.10% PD patients suffer from constipation. Among them, there was 47.59% having constipation before onset of motor symptoms. Compared with patients without constipation, patients with constipation reported lower daily water intake and less exercise, and were dominated by bradykinetic-rigid motor phenotype at onset and were prone to have anxiety, depression and insomnia. The time span between constipation and the onset of motor symptoms was (6.62 ± 9.32) years. Constipation occurred more frequently between 2 and 10 years before onset of motor symptoms. Patients suffering with constipation were then divided into two groups according to the time sequence of constipation and motor onset: ‘constipation pre-motor sign’ group and ‘constipation post-motor sign’ group. Total timespan from earliest initial symptoms to present was similar. Compared with ‘constipation post-motor sign’ group, the patients in ‘constipation pre-motor sign’ group experienced an older motor symptoms onset age, less serious motor symptoms, more serious constipation and less daily levodopa dosage.ConclusionsOur results supported that constipation could be a pre-motor symptom of PD. Different clinical characteristics were found in different constipation-loading time relative to motor symptoms. Research of constipation may be useful to better understand the early stages of PD and assessment of constipation with validated criteria may have utility as a risk factor for predicting PD in the prodromal phase.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A survey of subjective constipation in Parkinson’s disease patients in shanghai and literature review

et al. 2018

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“…Chronic constipation was assessed by ROME III Criteria [Appendix 4]. [16] Patients were diagnosed with functional constipation if they scored >2 points answering this questionnaire.…”

Section: Methodsmentioning

confidence: 99%

Prevalence of malnutrition in Parkinson's disease and correlation with gastrointestinal symptoms

Paul

Singh

Paul

et al. 2019

Ann Indian Acad Neurol

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Background:Parkinson's disease (PD) patients are at a higher risk of malnutrition with the overall prevalence estimated to be 3%–60%, but there are limited data in India regarding nutritional assessment of PD.Aim:This study aims to assess nutritional status of PD patients and correlate the disease factors and gastrointestinal tract (GIT) symptoms with nutritional status.Materials and Methods:The PD cohort was assessed for demographic factors, nutritional assessment was done by Mini-Nutritional Assessment (MNA) Scale, and GI symptoms were assessed by validated scales. Age- and gender-matched cohort controls were randomly selected to correlate the GIT symptoms influencing nutritional status. The study population was divided into two groups according to the MNA score; Group I malnourished/at risk of malnutrition (score <23.5) or Group II normal nutrition (>23.5). The two subgroups were then compared.Results:We assessed 75 patients of PD and 35 age- and gender-matched controls. According to anthropometric criteria, 23% of the PD population was underweight, and according to biochemical assessment, 17.3% had hypoalbuminemia along with anemia. According to MNA scale, 12% were malnourished and 45.3% were at risk of malnutrition. Hence, a total of 57.3% patients in Group I (with abnormal nutrition) as compared to 14% of the controls were at risk of malnutrition while none was found to be malnourished. In our study, GIT symptoms, such as sialorrhea and dysphagia was reported by 29.3% each and constipation by 41.3% patients. While comparing GI symptoms within the two MNA groups, there was statistically significant relationship of all GI manifestations, sialorrhea (P = 0.041), dysphagia (P = 0.00081), and constipation (P = 0.0042) with malnutrition. There was no statistical significant difference between groups for age (P = 0.54), gender (P = 0.903), and duration of disease (P = 0.743).Conclusions:The data suggest that about 45% of PD patients are at risk of malnourishment. MNA Score is a validated nutritional assessment tool and anthropometric or biochemical measures alone cannot identify all the malnourished population. PD patients at risk of malnutrition or malnourished do have symptoms of dysphagia, sialorrhea, and constipation as compared to PD patients with normal nutrition.

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“…To be included in the trial, participants must meet the following criteria: diagnosed with idiopathic PD according to the 2015 Movement Disorder Society criteria [ 11 ] ; diagnosed with constipation according to the Rome III criteria [ 12 ] ; between 30 and 80 years-of-age; have symptoms that are classified as scale 1 to 4 according to the Hoehn and Yahr scale; provide informed consent and confirm that they will be able to complete the whole treatment; and refrain from participating in other clinical trials during the study and follow-up period. The exclusion criteria are as follows: patients who do not take their medication under the guidance of a doctor or cannot take their medication regularly; patients with Parkinsonism-Plus syndrome or Secondary Parkinson syndrome caused by drugs, metabolic diseases, encephalitis, stroke, brain tumours, carbon monoxide poisoning, and other neurologic degenerative diseases; patients with organic intestinal lesions such as intestinal polyps, intestinal tuberculosis, Crohn disease, tumours, and ulcers; patients with secondary constipation caused by uremia, muscular dystrophy, multiple sclerosis, hypothyroidism and other system diseases; patients with severe heart, brain, liver, kidney, and blood diseases, as well as mental disorders or dementia; patients with serum creatinine, alanine aminotransferase, or aspartate transaminase levels more than twice the normal value; according to the investigators’ judgment, patients who are unable to cooperate throughout the study because of drug abuse or poor adherence (as judged by the investigators); patients who participated in other studies in the previous 2 weeks or are currently participating in other clinical trials, or have taken other TCM preparations in the previous 3 months; pregnant and lactating women; and patients or family members who are unwilling to cooperate or do not agree to sign the informed consent form.…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 99%

A randomized double-blind placebo-controlled multicenter trial of Bushen Yisui and Ziyin Jiangzhuo formula for constipation in Parkinson disease

et al. 2020

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Introduction: Constipation is a common nonmotor symptom of Parkinson disease (PD). Constipation can also impact patient's quality of life. Chinese herbal medicines have been used for the treatment of constipation in PD. This trial will evaluate the efficacy and safety of a Chinese herbal formula Bushen Yisui and Ziyin Jiangzhuo (BYZJ) for the treatment of constipation in PD. Methods and analysis: This randomized, double-blind, placebo-controlled, multicenter clinical trial will involve 4 hospitals in Beijing, China. The study will aim to recruit 90 PD patients with constipation between 30 and 80 years-of age with a score of 1 – 4 on the Hoehn and Yahr scale. Once recruited, Patients will be randomized into a BYZJ group or a placebo group in a 2:1 ratio. The trial will include a 1-week run-in period, a 4-week double-blind treatment period, a 4-week and a 12-week follow-up period. All patients will be educated about PD-related constipation during the run-in period. BYZJ granules and simulated granules will be administered twice daily for 4 weeks to the BYZJ group and the placebo group respectively. Assessments will be performed during run-in period, before the start of treatment (baseline, week 0), and at 4, 8, and 16 weeks. The primary outcome will be measured with the Constipation Severity Instrument, and secondary outcomes will be evaluated with the Patient Assessment of Constipation Quality of Life questionnaire, Bristol Stool Form Scale, Movement Disorders–Unified Parkinson Disease Rating Scale, Nonmotor Symptoms Scale, PD Sleep Scale, Parkinson Fatigue Scale-16. Laxative use (dose and frequency) will also be recorded. Intention-to-treat and per-protocol set analyses will be used to compare symptom improvement between the 2 groups. Any adverse events will be recorded. Discussion: If found effective and safe, BYZJ formula will be one of Chinese herb to treat constipation and even other nonmotor or motor symptoms in PD patients. The results will sustain the broader use of BYZJ formula in PD.

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A focus on Rome III criteria for the assessment of constipation in Parkinson's disease

Cited by 6 publications

References 6 publications

A survey of subjective constipation in Parkinson’s disease patients in shanghai and literature review

A survey of subjective constipation in Parkinson’s disease patients in shanghai and literature review

Prevalence of malnutrition in Parkinson's disease and correlation with gastrointestinal symptoms

A randomized double-blind placebo-controlled multicenter trial of Bushen Yisui and Ziyin Jiangzhuo formula for constipation in Parkinson disease

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