Anorectal Manometric Dysfunctions in Newly Diagnosed, Early-Stage Parkinson's Disease

Sung, Hye Young; Choi, Myung-Gyu; Kim, Yeong-In; Lee, Kwang Soo; Kim, Joong‐Seok

doi:10.3988/jcn.2012.8.3.184

Cited by 16 publications

(12 citation statements)

References 16 publications

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“…This functional outlet obstruction may cause both excessive straining and a sense of incomplete emptying, or sometimes, may induce painful defecation. 15–17 Another mechanism appears to involve the colonic musculature, which induces a slow passage of feces through the colon 14. Several studies have demonstrated considerably prolonged mean colonic transit time in PD patients 18…”

Section: Discussionmentioning

confidence: 99%

The Frequency and Severity of Gastrointestinal Symptoms in Patients with Early Parkinson’s Disease

Sung

Park

Kim

2014

JMD

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ObjectiveAlthough gastrointestinal dysfunctions occur in the majority of patients with Parkinson’s disease (PD), they are often unrecognized because many patients remain relatively asymptomatic in the early stage. We investigated the frequency of gastrointestinal symptoms in patients with PD using newly developed gastrointestinal symptom questionnaires.MethodsEarly PD patients with a symptom duration not exceeding 3 years were included in this study. All PD patients were evaluated using a questionnaire, which consisted of three relevant domains: oropharyngoesophageal (10 items); gastric (3 items); and intestinal-anorectal (7 items). The frequency of symptoms was calculated as a proportion with an item score ≥ 2.ResultsOf the 54 patients enrolled, 48 patients (88.9%) responded that bowel symptoms developed before the onset of Parkinsonian motor symptoms, and four patients reported that the onset of two types of symptoms (i.e., bowel and neurological) occurred approximately simultaneously, with only months between them. The frequencies of gastrointestinal symptoms are as follows: speech disturbance (40.7%), drooling (24.1%), sense of getting stuck (31.5%), choking (27.8%), globus pharyngis (16.7%), repetitive deglutition (29.6%), pain during swallowing (5.6%), food regurgitation (3.7%), acid reflux (7.4%), nausea/vomiting (11.1%), early satiety (16.7%), postprandial fullness (14.8%), epigastric soreness (9.3%), abdominal pain (3.7%), constipation (46.3%), excessive strain during defecation (33.3%), fecal incontinence (7.4%), tenesmus (20.4%), loose stool or diarrhea (3.7%), and difficulty in relaxing anal sphincter (11.1%). Two patients were scored at zero.ConclusionsOur findings confirm that gastrointestinal dysfunction occurs in early PD in relatively high frequency.

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Section: Discussionmentioning

confidence: 99%

The Frequency and Severity of Gastrointestinal Symptoms in Patients with Early Parkinson’s Disease

Sung

Park

Kim

2014

JMD

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“…Constipation is a common nonmotor symptom of neurological conditions [1] including Parkinson's [2, 3]. Constipation is the most common gastrointestinal complaint reported in people with Parkinson's (PwP) and is estimated to impact 27–67% of all sufferers [4, 5].…”

Section: Introductionmentioning

confidence: 99%

Abdominal Massage for the Relief of Constipation in People with Parkinson’s: A Qualitative Study

McClurg

Walker

Aitchison

et al. 2016

Parkinson's Disease

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Objectives. To explore the experiences of people with Parkinson's (PwP) who suffer from constipation, the impact this has on their lives, and the effect of using lifestyle changes and abdominal massage as a form of constipation management. Method. Fourteen semistructured interviews were completed (8 males and 6 females; mean age 72.2 years) at the end of a care programme, which consisted of either lifestyle advice and abdominal massage (intervention group; n = 7) or lifestyle advice only (control group; n = 7). Data were analysed using constant-comparison techniques and Framework methods. Themes and key quotes were identified to depict major findings. Findings. Four key themes were identified: (i) the adverse impact of bowel problems on quality of life; (ii) positive experience of behaviour adjustments: experimentation; (iii) abdominal massage as a dynamic and relaxing tool: experiential learning (intervention group only); (iv) abdominal massage as a contingency plan: hesitation (control group only). Constipation was reported as having a significant impact on quality of life. Participants in both groups perceived lifestyle advice to relieve symptoms. Specific improvements were described in those who also received the abdominal massage. Conclusions. Both lifestyle advice and abdominal massage were perceived to be beneficial in relieving symptoms of constipation for PwP.

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“…Patients with PD often experience nonmotor symptoms to include orthostatic hypotension, urinary urgency, sexual dysfunction, disorders of sleep, psychosis, depression, and dementia. 7 With advancing PD, an inadequate fluid intake, dehydration, and poor intake complicate constipation. The cause of constipation is slow or impaired colonic transit time (CTT), weak abdominal strain (from rigidity and reduced axial muscle contractility), and abnormal motor control of the anal sphincter.…”

Section: Pd and Constipationmentioning

confidence: 99%

Management of Constipation in Patients With Parkinson Disease

Noll¹

2013

Journal of Hospice & Palliative Nursing

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Constipation management in Parkinson disease can be challenging. Physiologically, there is a slowed colonic transit time, hypokinesia of abdominal muscular due to rigidity, and central pathology as well as a functional outlet obstruction. This is because of paradoxical external anal sphincter contraction when there should be relaxation for defecation. The paradoxical contraction is likened to a focal dystonia similar to other dystonias occurring in the rest of the body. A recent study showed the effect of decreasing anal dystonia with added levadopa in de novo patients. However, more studies are needed to replicate the effect. Often, the treatment for chronic constipation is based on provider and patient experience, with more studies needed in this area as well. Complicating factors include patient age, polypharmacy, multiple comorbids, dietary factors, and limited mobility.

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Anorectal Manometric Dysfunctions in Newly Diagnosed, Early-Stage Parkinson's Disease

Cited by 16 publications

References 16 publications

The Frequency and Severity of Gastrointestinal Symptoms in Patients with Early Parkinson’s Disease

The Frequency and Severity of Gastrointestinal Symptoms in Patients with Early Parkinson’s Disease

Abdominal Massage for the Relief of Constipation in People with Parkinson’s: A Qualitative Study

Management of Constipation in Patients With Parkinson Disease

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