Skip to main content

Intestinal Dysfunction in Parkinson’s Disease

  • Chapter
  • First Online:

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Intestinal involvement in Parkinson’s disease (PD) has been known since James Parkinson’s initial description of the disease in 1817. Relatively little attention has been directed toward small intestinal dysfunction in PD, but some evidence has accumulated that small intestinal motility may, indeed, be impaired in PD. However, the clinical consequences of any such dysfunction have not been clearly delineated. Much more information is available regarding colonic and anorectal dysfunction in PD. Diminished bowel movement frequency, presumably reflecting colonic dysmotility with consequent slowed colonic transit, is present in a significant percentage of individuals with PD, reported figures ranging from 20 to 77%. Anorectal dysfunction, characterized by both excessive straining and a sense of incomplete emptying, develops even more frequently in PD, affecting more than 60% of patients. Both central and enteric nervous system dysfunction may have a role in the generation of these intestinal and anorectal abnormalities. Recognition of two components of intestinal dysfunction in PD—slow-transit constipation and anorectal defecatory dysfunction—will hopefully open the therapeutic door to more specific and effective treatment for these troubling and occasionally disabling features of PD.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Parkinson J. An essay on the shaking palsy. London: Whittingham and Rowland; 1817.

    Google Scholar 

  2. Eadie MJ, Tyrer JH. Alimentary disorder in parkinsonism. Aust Ann Med. 1965;14:13–22.

    PubMed  CAS  Google Scholar 

  3. Korczyn AD. Autonomic nervous system disturbances in Parkinson’s disease. Adv Neurol. 1990;53:463–8.

    PubMed  CAS  Google Scholar 

  4. Edwards LL, Pfeiffer RF, Quigley EMM, Hofman R, Baluff M. Gastrointestinal symptoms in Parkinson’s disease. Mov Disord. 1991;6:151–6.

    Article  PubMed  CAS  Google Scholar 

  5. Edwards LL, Quigley EMM, Hofman R, Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease: frequency and pathophysiology. Neurology. 1992;42:726–32.

    Article  PubMed  CAS  Google Scholar 

  6. Edwards LL, Quigley EMM, Hofman R, Pfeiffer RF. Gastrointestinal symptoms in Parkinson’s disease: 18 month follow-up study. Mov Disord. 1993;8:83–6.

    Article  PubMed  CAS  Google Scholar 

  7. Edwards LL, Quigley EMM, Harned RK, Hofman R, Pfeiffer RF. Characterization of swallowing and defecation in Parkinson’s disease. Am J Gastroenterol. 1994;89:15–25.

    PubMed  CAS  Google Scholar 

  8. Pfeiffer RF, Quigley EMM. Gastrointestinal motility problems in patients with Parkinson’s disease: epidemiology, pathophysiology and guidelines for management. CNS Drugs. 1999;11:435–8.

    Article  Google Scholar 

  9. Quigley EMM. Gastrointestinal dysfunction in Parkinson’s disease. Semin Neurol. 1996;16:245–50.

    Article  PubMed  CAS  Google Scholar 

  10. Quigley EMM. Epidemiology and pathophysiology of gastrointestinal manifestations in Parkinson’s disease. In: Corazziari E, editor. NeUroGastro-enterology. Berlin: deGruyter; 1996. p. 167–78.

    Google Scholar 

  11. Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Clin Neurosci. 1998;5:136–46.

    PubMed  CAS  Google Scholar 

  12. Quigley EMM. Gastrointestinal features. In: Factor SA, Weiner WJ, editors. Parkinson’s disease. Diagnosis and clinical management. New York: Demos; 2002. p. 87–93.

    Google Scholar 

  13. Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol. 2003;2:107–16.

    Article  PubMed  Google Scholar 

  14. Pfeiffer RF. Gastrointestinal, urological, and sexual dysfunction in Parkinson’s disease. Mov Disord. 2010;25 Suppl 1:S94–7.

    Article  PubMed  Google Scholar 

  15. Pfeiffer RF. Gastrointestinal dysfunction in Parkinson’s disease. Parkinsonism Relat Disord. 2011;17:10–5.

    Article  PubMed  Google Scholar 

  16. Jost WH. Gastrointestinal dysfunction in Parkinson’s disease. J Neurol Sci. 2010;289:69–73.

    Article  PubMed  CAS  Google Scholar 

  17. Sakakibara R, Uchiyama T, Yamanishi T, Shirai K, Hattori T. Bladder and bowel dysfunction in Parkinson’s disease. J Neural Transm. 2008;115:443–60.

    Article  PubMed  CAS  Google Scholar 

  18. Sakakibara R, Kishi M, Ogawa E, et al. Bladder, bowel, and sexual dysfunction in Parkinson’s disease. Parkinsons Dis. 2011;2011:924605.

    PubMed  Google Scholar 

  19. Makaroff L, Gunn A, Gervasoni C, Richy F. Gastrointestinal disorders in Parkinson’s disease: prevalence and health outcomes in a US claims database. J Parkinsons Dis. 2011;1:65–74.

    Google Scholar 

  20. Keljo DJ, Gariepy CE. Anatomy, histology, embryology, and developmental anomalies of the small and large intestine. In: Feldman M, Friedman LS, Sleisenger MH, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. 7th ed. Philadelphia: Saunders; 2002. p. 1643–63.

    Google Scholar 

  21. Cheng LK, O’Grady G, Du P, Egbuji JU, Windsor JA, Pullan AJ. Gastrointestinal system. Syst Biol Med. 2010;2:65–79.

    Google Scholar 

  22. Sanders KM, Koh SD, Ward SM. Interstitial cells of Cajal as pacemakers in the gastrointestinal tract. Annu Rev Physiol. 2006;68:307–43.

    Article  PubMed  CAS  Google Scholar 

  23. Lammers WJ, Stephen B. Origin and propagation of individual slow waves along the intact feline small intestine. Exp Physiol. 2008;93:334–46.

    Article  PubMed  Google Scholar 

  24. Lammers WJ, Slack JR, Stephen B, Pozzan O. The spatial behaviour of spike patches in the feline gastro-duodenal junction in vitro. Neurogastroenterol Motil. 2000;12:467–73.

    Article  PubMed  CAS  Google Scholar 

  25. Andrews JM, Dent J. Small intestinal motor physiology. In: Feldman M, Friedman LS, Sleisenger MH, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. 7th ed. Philadelphia: Saunders; 2002. p. 1665–78.

    Google Scholar 

  26. Davies KN, King D, Billington D, Barrett JA. Intestinal permeability and orocaecal transit time in elderly patients with Parkinson’s disease. Postgrad Med J. 1996;72:164–7.

    Article  PubMed  CAS  Google Scholar 

  27. Bozeman T, Anuras S, Hutton T, Mikeska C. Small intestinal manometry in Parkinson’s disease. Gastroenterology. 1990;99:1202 (abstract).

    Google Scholar 

  28. Lewitan A, Nathanson L, Slade WR. Megacolon and dilatation of the small bowel in parkinsonism. Gastroenterology. 1952;17:367–74.

    Google Scholar 

  29. Eaker EY, Bixler GB, Dunn AJ, Moreshead WV, Mathias JR. Chronic alterations in jejunal myoelectric activity in rats due to MPTP. Am J Physiol. 1987;253:G809–15.

    PubMed  CAS  Google Scholar 

  30. Banach T, Zurowski D, Kania D, Thor PJ. Myoelectrical activity of small intestine in rats with experimental Parkinson’s disease. Folia Med Cracov. 2005;46:119–24.

    PubMed  Google Scholar 

  31. Rao SSC, Camilleri M, Hasler WL, et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil. 2011;23:8–23.

    Article  PubMed  CAS  Google Scholar 

  32. Emmanuel AV, Roy AJ, Nicholls TJ, Kamm MA. Prucalopride, a systemic enterokinetic, for the treatment of constipation. Aliment Pharmacol Ther. 2002;16:1347–56.

    Article  PubMed  CAS  Google Scholar 

  33. Gabrielli M, Bonazzi P, Scarpellini E, et al. Prevalence of small intestinal bacterial overgrowth in Parkinson’s disease. Mov Disord. 2011;26:889–92.

    Article  PubMed  Google Scholar 

  34. Strang RR. The association of gastro-duodenal ulceration and Parkinson’s disease. Med J Aust. 1965;1(23):842–3.

    PubMed  CAS  Google Scholar 

  35. Marshall BJ, Warren JR. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984;1:1311–5.

    Article  PubMed  CAS  Google Scholar 

  36. Altschuler E. Gastric Helicobacter pylori infection as a cause of idiopathic Parkinson disease and non-arteric anterior optic ischemic neuropathy. Med Hypotheses. 1996;47:413–4.

    Article  PubMed  CAS  Google Scholar 

  37. Dobbs RJ, Dobbs SM, Weller C, et al. Helicobacter hypothesis for idiopathic parkinsonism: before and beyond. Helicobacter. 2008;13:309–22.

    Article  PubMed  Google Scholar 

  38. Nielsen HH, Qiu J, Friis S, Wermuth L, Ritz B. Treatment for Helicobacter pylori infection and risk of Parkinson’s disease in Denmark. Eur J Neurol. 2012;19(6):864–9. doi:10.1111/j.1468-1331.2011.03643.x.

    Article  PubMed  CAS  Google Scholar 

  39. Pierantozzi M, Pietroiusti A, Sancesario G, et al. Reduced L-dopa absorption and increased clinical fluctuations in Helicobacter pylori-infected Parkinson’s disease patients. Neurol Sci. 2001;22:89–91.

    Article  PubMed  CAS  Google Scholar 

  40. Pierantozzi M, Pietroiusti A, Galante A, et al. Helicobacter pylori-induced reduction of acute levodopa absorption in Parkinson’s disease patients. Ann Neurol. 2001;50:686–7.

    Article  PubMed  CAS  Google Scholar 

  41. Pierantozzi M, Pietroiusti A, Brusa L, et al. Helicobacter pylori eradication and L-dopa absorption in patients with PD and motor fluctuations. Neurology. 2006;66:1824–9.

    Article  PubMed  CAS  Google Scholar 

  42. Lee WY, Yoon WT, Shin HY, Jeon SH, Rhee P-L. Helicobacter pylori infection and motor fluctuations in patients with Parkinson’s disease. Mov Disord. 2008;23:1696–700.

    Article  PubMed  Google Scholar 

  43. Lyte M. Microbial endocrinology as a basis for improved L-DOPA bioavailability in Parkinson’s patients treated for Helicobacter pylori. Med Hypotheses. 2010;74:895–7.

    Article  PubMed  CAS  Google Scholar 

  44. Rees K, Stowe R, Patel S, et al. Helicobacter pylori eradication for Parkinson’s disease. Cochrane Database Sys Rev. 2011;(11):CD008453.

    Google Scholar 

  45. Cook IJ, Brookes SJ. Motility of the large intestine. In: Feldman M, Friedman LS, Sleisenger MH, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. 7th ed. Philadelphia: Saunders; 2002. p. 1679–91.

    Google Scholar 

  46. Stark ME. Challenging problems presenting as constipation. Am J Gastroenterol. 1999;94:567–74.

    Article  PubMed  CAS  Google Scholar 

  47. Bassotti G, Maggio D, Battaglia E, et al. Manometric investigation of anorectal function in early and late stage Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2000;68:768–70.

    Article  PubMed  CAS  Google Scholar 

  48. Bassotti G, Germani U, Fiorella S, Roselli P, Brunori P, Whitehead WE. Intact colonic motor response to sudden awakening from sleep in patients with chronic idiopathic (slow-transit) constipation. Dis Colon Rectum. 1998;41:1550–6.

    Article  PubMed  CAS  Google Scholar 

  49. Ashraf W, Park F, Lof J, Quigley EM. An examination of reliability of reported stool frequency in the diagnosis of idiopathic constipation. Am J Gastroenterol. 1996;91:26–32.

    PubMed  CAS  Google Scholar 

  50. Schwab RS, England AC. Parkinson’s disease. J Chron Dis. 1958;8:488–509.

    Article  PubMed  CAS  Google Scholar 

  51. Siddiqui MF, Rast S, Lynn MJ, Auchus AP, Pfeiffer RF. Autonomic dysfunction in Parkinson’s disease: a comprehensive symptom survey. Parkinsonism Relat Disord. 2002;8:277–84.

    Article  PubMed  CAS  Google Scholar 

  52. Stocchi F, Badiali D, Vacca L, et al. Anorectal function in multiple system atrophy and Parkinson’s disease. Mov Disord. 2000;15:71–6.

    Article  PubMed  CAS  Google Scholar 

  53. Sakakibara R, Shinotoh H, Uchiyama T, et al. Questionnaire-based assessment of pelvic organ dysfunction in Parkinson’s disease. Auton Neurosci. 2001;92:76–85.

    Article  PubMed  CAS  Google Scholar 

  54. Abbott RD, Petrovitch H, White LR, et al. Frequency of bowel movements and the future risk of Parkinson’s disease. Neurology. 2001;57:456–62.

    Article  PubMed  CAS  Google Scholar 

  55. Abbott RD, Ross GW, Petrovitch H, et al. Bowel movement frequency in late-life and incidental Lewy bodies. Mov Disord. 2007;22:1581–6.

    Article  PubMed  Google Scholar 

  56. Petrovitch H, Abbott RD, Ross GW, et al. Bowel movement frequency in late-life and substantia nigra neuron density at death. Mov Disord. 2009;24:371–6.

    Article  PubMed  Google Scholar 

  57. Savica R, Carlin JM, Grossardt BR, et al. Medical records documentation of constipation preceding Parkinson disease. Neurology. 2009;73:1752–8.

    Article  PubMed  CAS  Google Scholar 

  58. Gao X, Chen H, Schwarzschild MA, Ascherio A. A prospective study of bowel movement frequency and risk of Parkinson’s disease. Am J Epidemiol. 2011;174:546–51.

    Article  PubMed  Google Scholar 

  59. Jost WH, Schimrigk K. Constipation in Parkinson’s disease. Klin Wochenschr. 1991;69:906–9.

    Article  PubMed  CAS  Google Scholar 

  60. Jost WH, Schimrigk K. The effect of cisapride on delayed colon transit time in patients with idiopathic Parkinson’s disease. Wien Klin Wochenschr. 1994;106:673–6.

    PubMed  CAS  Google Scholar 

  61. Sakakibara R, Odaka T, Uchiyama T, et al. Colonic transit time and rectoanal videomanometry in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2003;74:268–72.

    Article  PubMed  CAS  Google Scholar 

  62. Jost WH, Schrank B. Defecatory disorders in de novo parkinsonians – colonic transit and electromyogram of the external anal sphincter. Wien Klin Wochenschr. 1998;110:535–7.

    PubMed  CAS  Google Scholar 

  63. Ashraf W, Pfeiffer RF, Park F, Lof J, Quigley EMM. Constipation in Parkinson’s disease: objective assessment and response to psyllium. Mov Disord. 1997;12:946–51.

    Article  PubMed  CAS  Google Scholar 

  64. Bueno L, Gue M, Fabre C, Junien JL. Involvement of central dopamine and D1 receptors in stress-induced colonic motor alterations in rats. Brain Res Bull. 1992;29:135–40.

    Article  PubMed  CAS  Google Scholar 

  65. Ding YQ, Zheng HX, Wang DS, Lu BZ, Xu JQ. Localization of Barrington’s nucleus in the pontine dorsolateral tegmentum of the rabbit. J Hirnforsch. 1999;39:375–81.

    PubMed  CAS  Google Scholar 

  66. Pavcovich LA, Yang M, Miselis RR, Valentino RJ. Novel role for the pontine micturition center, Barrington’s nucleus: evidence for coordination of colonic and forebrain activity. Brain Res. 1998;784:355–61.

    Article  PubMed  CAS  Google Scholar 

  67. Valentino RJ, Miselis RR, Pavcovich LA. Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions. Trends Pharmacol Sci. 1999;20:253–60.

    Article  PubMed  CAS  Google Scholar 

  68. Vizzard MA, Brisson M, de Groat WC. Transneuronal labeling of neurons in the adult rat central nervous system following inoculation of pseudorabies virus into the colon. Cell Tissue Res. 2000;299:9–26.

    Article  PubMed  CAS  Google Scholar 

  69. Kupsky WJ, Grimes MM, Sweeting J, Bertsch R, Cote LJ. Parkinson’s disease and megacolon: concentric hyaline inclusions (Lewy bodies) in enteric ganglion cells. Neurology. 1987;37:1253–5.

    Article  PubMed  CAS  Google Scholar 

  70. Wakabayashi K, Takahashi H, Ohama E, Ikuta F. Parkinson’s disease: an immunohistochemical study of Lewy-body containing neurons in the enteric nervous system. Acta Neuropathol. 1990;79:581–3.

    Article  PubMed  CAS  Google Scholar 

  71. Wakabayashi K, Takahashi H, Ohama E, Takeda S, Ikuta F. Lewy bodies in the visceral autonomic nervous system in Parkinson’s disease. In: Narabayashi H et al., editors. Parkinson’s disease. From basic research to treatment, Advances in neurology, vol. 60. New York: Raven; 1993. p. 609–12.

    Google Scholar 

  72. Singaram C, Ashraf W, Torbey C, Sengupta A, Pfeiffer R, Quigley EMM. Dopaminergic defect of enteric nervous system in Parkinson’s disease patients with chronic constipation. Lancet. 1995;346:861–4.

    Article  PubMed  CAS  Google Scholar 

  73. Braak H, de Vos RA, Bohl J, Del Tredici K. Gastric alpha-synuclein immunoreactive inclusions in Meissner’s and Auerbach’s plexuses in cases staged for Parkinson’s disease-related brain pathology. Neurosci Lett. 2006;396:67–72.

    Article  PubMed  CAS  Google Scholar 

  74. Lebouvier T, Chaumette T, Damier P, et al. Pathological lesions in colonic biopsies during Parkinson’s disease. Gut. 2008;57:1741–3.

    Article  PubMed  CAS  Google Scholar 

  75. Lebouvier T, Neunlist M, des Varannes SB, et al. Colonic biopsies to assess the neuropathology of Parkinson’s disease and its relationship with symptoms. PLoS One. 2010;5:e12728.

    Article  PubMed  CAS  Google Scholar 

  76. Lebouvier T, Tasselli M, Paillusson S, Pouclet H, Neunlist M, Derkinderen P. Biopsable neural tissues: toward new biomarkers for Parkinson’s disease? Front Psychiatry. 2010;1:128.

    Article  PubMed  Google Scholar 

  77. Beach TG, Adler CH, Sue LI, et al. Multi-organ distribution of phosphorylated α-synuclein histopathology in subjects with Lewy body disorders. Acta Neuropathol. 2010;119:689–702.

    Article  PubMed  CAS  Google Scholar 

  78. Shannon KM, Keshavarzian A, Mutlu E, et al. Alpha-synuclein in colonic submucosa in early untreated Parkinson’s disease. Mov Disord. 2012;27(6):709–15. doi:10.1002/mds.23838.

    Article  PubMed  Google Scholar 

  79. Forsyth CB, Shannon KM, Kordower JH, et al. Increased intestinal permeability correlates with sigmoid mucosa alpha-synuclein staining and endotoxin exposure markers in early Parkinson’s disease. PLoS One. 2011;6:e28032.

    Article  PubMed  CAS  Google Scholar 

  80. Zhao RH, Baig MK, Thaler KJ, et al. Reduced expression of serotonin receptor(s) in the left colon of patients with colonic inertia. Dis Colon Rectum. 2003;46:81–6.

    Article  PubMed  Google Scholar 

  81. Lyford GL, He CL, Soffer E, et al. Pan-colonic decrease in interstitial cells of Cajal in patients with slow transit constipation. Gut. 2002;51:496–501.

    Article  PubMed  CAS  Google Scholar 

  82. Jain D, Moussa K, Tandon M, Culpepper-Morgan J, Proctor DD. Role of interstitial cells of Cajal in motility disorders of the bowel. Am J Gastroenterol. 2003;98:618–24.

    Article  PubMed  Google Scholar 

  83. Wiesel PH, Norton C, Brazzelli M. Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane Database Syst Rev. 2001;(4):CD002115.

    Google Scholar 

  84. Müller-Lissner SA. Effect of wheat bran on weight of stool and gastrointestinal transit time: a meta-analysis. Br Med J. 1988;296:615–7.

    Article  Google Scholar 

  85. Corazziari E, Badiali D. Management of lower gastrointestinal tract dysfunction. Semin Neurol. 1996;16:289–96.

    Article  PubMed  CAS  Google Scholar 

  86. Astarloa R, Mena MA, Sanchez V, de la Vega L, de Yebenes JG. Clinical and pharmacokinetic effects of a diet rich in insoluble fiber on Parkinson’s disease. Clin Neuropharmacol. 1992;15:375–80.

    Article  PubMed  CAS  Google Scholar 

  87. Cassani E, Privitera G, Pezzoli G, et al. Use of probiotics for the treatment of constipation in Parkinson’s disease patients. Minerva Gastroenterol Dietol. 2011;57:117–21.

    PubMed  CAS  Google Scholar 

  88. Lederle FA, Busch DL, Mattox KM, West MJ, Aske DM. Cost-effective treatment of constipation in the elderly: a randomized double-blind comparison of sorbitol and lactulose. Am J Med. 1990;89:597–601.

    Article  PubMed  CAS  Google Scholar 

  89. Corazziari E, Badiali D, Habib FI, et al. Small volume isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in treatment of chronic nonorganic constipation. Dig Dis Sci. 1996;41:1636–42.

    Article  PubMed  CAS  Google Scholar 

  90. Eichhorn TE, Oertel WH. Macrogol 3350/electrolyte improves constipation in Parkinson’s disease and multiple system atrophy. Mov Disord. 2001;16:1176–7.

    Article  PubMed  CAS  Google Scholar 

  91. Zangaglia R, Martignoni E, Glorioso M, et al. Macrogol for the treatment of constipation in Parkinson’s disease. A randomized placebo-controlled study. Mov Disord. 2007;22:1239–44.

    Article  PubMed  Google Scholar 

  92. Seppi K, Weintraub D, Coelho M, et al. The Movement Disorder Society evidence-based medicine review update: treatments for the non-motor symptoms of Parkinson’s disease. Mov Disord. 2011;26 Suppl 3:S42–80.

    Article  PubMed  Google Scholar 

  93. Zesiewicz TA, Sullivan KL, Arnulf I, et al. Practice parameter: treatment of nonmotor symptoms of Parkinson disease. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2010;74:924–31.

    Article  PubMed  CAS  Google Scholar 

  94. Tack J, Camilleri M, Chang L, et al. Systematic review: cardiovascular safety profile of 5-HT agonists developed for gastrointestinal disorders. Aliment Pharmacol Ther. 2012;35:745–67.

    Article  PubMed  CAS  Google Scholar 

  95. Jost WH, Schimrigk K. Cisapride treatment of constipation in Parkinson’s disease. Mov Disord. 1993;8:339–43.

    Article  PubMed  CAS  Google Scholar 

  96. Jost WH, Schimrigk K. Long-term results with cisapride in Parkinson’s disease. Mov Disord. 1997;12:423–5.

    Article  PubMed  CAS  Google Scholar 

  97. Sullivan KL, Staffetti JF, Hauser RA, Dunne PB, Zesiewicz TA. Tegaserod (Zelnorm) for the treatment of constipation in Parkinson’s disease. Mov Disord. 2006;21:115–6.

    Article  PubMed  Google Scholar 

  98. Morgan JC, Sethi KD. Tegaserod in constipation associated with Parkinson disease. Clin Neuropharmacol. 2007;30:52–4.

    Article  PubMed  CAS  Google Scholar 

  99. Liu Z, Sakakibara R, Odaka T, et al. Mosapride citrate, a novel 5-HT4 agonist and partial 5-HT3 antagonist, ameliorates constipation in parkinsonian patients. Mov Disord. 2005;20:680–6.

    Article  PubMed  Google Scholar 

  100. Coremans G, Kerstens R, De Pauw M, Stevens M. Prucalopride is effective in patients with severe chronic constipation in whom laxatives fail to provide adequate relief. Results of a double-blind, placebo-controlled clinical trial. Digestion. 2003;67:82–9.

    Article  PubMed  CAS  Google Scholar 

  101. Lembo AJ, Johanson JF, Parkman HP, Rao SS, Miner Jr PB, Ueno R. Long-term safety and effectiveness of lubiprostone, a chloride channel (CIC-2) activator, in patients with chronic idiopathic constipation. Dig Dis Sci. 2011;56:2639–45.

    Article  PubMed  CAS  Google Scholar 

  102. Sadjadpour K. Pyridostigmine bromide and constipation in Parkinson’s disease. JAMA. 1983;249:1148.

    Article  PubMed  CAS  Google Scholar 

  103. Koornstra JJ, Klaver NS, ter Maaten JC, Limburg AJ, van der Jagt EJ, van der Werf TS. Neostigmine treatment of acute pseudo-obstruction of colon (Ogilvie syndrome). Ned Tijdschr Geneeskd. 2001;145:586–9.

    PubMed  CAS  Google Scholar 

  104. Bharucha AE, Low PA, Camilleri M, Burton D, Gehrking TL, Zinsmeister AR. Pilot study of pyridostigmine in constipated patients with autonomic neuropathy. Clin Auton Res. 2008;18:194–202.

    Article  PubMed  Google Scholar 

  105. Parkman HP, Rao SSC, Reynolds JC, et al. Neurotrophin-3 improves functional constipation. Am J Gastroenterol. 2003;98:1338–47.

    Article  PubMed  CAS  Google Scholar 

  106. Pfeiffer RF, Markopoulou K, Quigley EM, Stambler N, Cedarbaum JM. Effect of NT-3 on bowel function in Parkinson’s disease. Mov Disord. 2002;17:S223–4 (abstract).

    Google Scholar 

  107. Soffer EE, Metcalf A, Launspach J. Misoprostol is effective treatment for patients with severe chronic constipation. Dig Dis Sci. 1994;39:929–33.

    Article  PubMed  CAS  Google Scholar 

  108. Roarty TP, Weber F, Soykan I, McCallum RW. Misoprostol in the treatment of chronic refractory constipation: results of a long-term open label trial. Aliment Pharmacol Ther. 1997;11:1059–66.

    Article  PubMed  CAS  Google Scholar 

  109. Verne GN, Davis RH, Robinson ME, Gordon JM, Eaker EY, Sninsky CA. Treatment of chronic constipation with colchicine: randomized, double-blind, placebo-controlled, crossover trial. Am J Gastroenterol. 2003;98:1112–6.

    PubMed  CAS  Google Scholar 

  110. Sandyk R, Gillman MA. Colchicine ameliorates constipation in Parkinson’s disease. J R Soc Med. 1984;77:1066.

    PubMed  CAS  Google Scholar 

  111. Woitalla D, Goetze O. Treatment approaches of gastrointestinal dysfunction in Parkinson’s disease, therapeutical options and future perspectives. J Neurol Sci. 2011;310:152–8.

    Article  PubMed  CAS  Google Scholar 

  112. Wald A. Slow transit constipation. Curr Treat Options Gastroenterol. 2002;5:279–83.

    Article  PubMed  Google Scholar 

  113. Ogawa E, Sakakibara R, Kishi M, Tateno F. Constipation triggered the malignant syndrome in Parkinson’s disease. Neurol Sci. 2012;33:347–50.

    Article  PubMed  Google Scholar 

  114. Caplan LH, Jacobson HG, Rubinstein BM, Rotman MZ. Megacolon and volvulus in Parkinson’s disease. Radiology. 1965;85:73–9.

    PubMed  CAS  Google Scholar 

  115. Rosenthal MJ, Marshall CE. Sigmoid volvulus in association with parkinsonism. Report of four cases. J Am Geriatr Soc. 1987;35:683–4.

    PubMed  CAS  Google Scholar 

  116. Madoff D, Williams JG, Caushaj PF. Fecal incontinence. N Engl J Med. 1992;326:1002–7.

    Article  PubMed  CAS  Google Scholar 

  117. Altomare DF, Rinaldi M, Veglia A, Guglielmi A, Sallustio PL, Tripoli G. Contribution of posture to the maintenance of anal continence. Int J Colorectal Dis. 2001;16:51–4.

    Article  PubMed  CAS  Google Scholar 

  118. Hajivassiliou CA, Carter KB, Finlay IG. Anorectal angle enhances faecal continence. Br J Surg. 1996;83:53–6.

    Article  PubMed  CAS  Google Scholar 

  119. Parks AG. Anorectal incontinence. Proc R Soc Med. 1975;68:681–90.

    PubMed  CAS  Google Scholar 

  120. Ashraf W, Wszolek ZK, Pfeiffer RF, et al. Anorectal function in fluctuating (on-off) Parkinson’s disease: evaluation by combined anorectal manometry and electromyography. Mov Disord. 1995;10:650–7.

    Article  PubMed  CAS  Google Scholar 

  121. Normand MM, Ashraf W, Quigley EM, et al. Simultaneous electromyography and manometry of the anal sphincters in parkinsonian patients: technical considerations. Muscle Nerve. 1996;19:110–1.

    PubMed  CAS  Google Scholar 

  122. Ashraf W, Pfeiffer RF, Quigley EMM. Anorectal manometry in the assessment of anorectal function in Parkinson’s disease: a comparison with chronic idiopathic constipation. Mov Disord. 1994;9:655–63.

    Article  PubMed  CAS  Google Scholar 

  123. Kim J-S, Sung HY, Lee K-S, Kim Y-I, Kim H-T. Anorectal dysfunctions in Parkinson’s disease. J Neurol Sci. 2011;310:144–51.

    Article  PubMed  Google Scholar 

  124. Mathers SE, Kempster PA, Swash M, Lees AJ. Constipation and paradoxical puborectalis contraction in anismus and Parkinson’s disease: a dystonic phenomenon? J Neurol Neurosurg Psychiatry. 1988;51:1503–7.

    Article  PubMed  CAS  Google Scholar 

  125. Mathers SE, Kempster PA, Law PJ, et al. Anal sphincter dysfunction in Parkinson’s disease. Arch Neurol. 1989;46:1061–4.

    Article  PubMed  CAS  Google Scholar 

  126. Voderholzer WA, Neuhaus DA, Klauser AG, Tzavella K, Muller-Lissner SA, Schindlbeck NE. Paradoxical sphincter contraction is rarely indicative of anismus. Gut. 1997;41:258–62.

    Article  PubMed  CAS  Google Scholar 

  127. Schouten WR, Briel JW, Auwerda JJ, et al. Anismus: fact or fiction? Dis Colon Rectum. 1997;40:1033–41.

    Article  PubMed  CAS  Google Scholar 

  128. Beer-Gabel M, Teshler M, Schechtman E, Zbar AP. Dynamic transperineal ultrasound vs. defecography in patients with evacuatory difficulty: a pilot study. Int J Colorectal Dis. 2004;19:60–7.

    Article  PubMed  CAS  Google Scholar 

  129. Reiner CS, Tutuian R, Solopova AE, Pohl D, Marincek B, Weishaupt D. MR defecography in patients with dyssynergic defecation: spectrum of imaging findings and diagnostic value. Br J Radiol. 2011;84:136–44.

    Article  PubMed  CAS  Google Scholar 

  130. Edwards LL, Quigley EMM, Harned RK, Hofman R, Pfeiffer RF. Defecatory function in Parkinson’s disease: response to apomorphine. Ann Neurol. 1993;33:490–3.

    Article  PubMed  CAS  Google Scholar 

  131. Tateno F, Sakakibara R, Yokoi Y, et al. Levodopa ameliorated anorectal constipation in de novo Parkinson’s disease: the QL-GAT study. Parkinsonism Relat Disord. 2011;17:662–6.

    Article  PubMed  Google Scholar 

  132. Albanese A, Maria G, Bentivoglio AR, Brisinda G, Cassetta E, Tonali P. Severe constipation in Parkinson’s disease relieved by botulinum toxin. Mov Disord. 1997;12:764–6.

    Article  PubMed  CAS  Google Scholar 

  133. Albanese A, Brisinda G, Bentivoglio AR, Maria G. Treatment of outlet obstruction constipation in Parkinson’s disease with botulinum neurotoxin A. Am J Gastroenterol. 2003;98:1439–40.

    Article  PubMed  CAS  Google Scholar 

  134. Cadeddu F, Bentivoglio AR, Brandara F, Marniga G, Brisinda G, Maria G. Outlet type constipation in Parkinson’s disease: results of botulinum toxin treatment. Aliment Pharmacol Ther. 2005;22:997–1003.

    Article  PubMed  CAS  Google Scholar 

  135. Jost WH, Schanne S, Mlitz H, Schimrigk K. Perianal thrombosis following injection therapy into the external anal sphincter using botulinum toxin. Dis Colon Rectum. 1995;38:781.

    Article  PubMed  CAS  Google Scholar 

  136. Chiu C-M, Wang C-P, Sung W-H, Huang S-F, Chiang S-C, Tsai P-Y. Functional magnetic stimulation in constipation associated with Parkinson’s disease. J Rehabil Med. 2009;41:1085–9.

    Article  PubMed  Google Scholar 

  137. McKee RF, McEnroe L, Anderson JH, Finlay IG. Identification of patients likely to benefit from biofeedback for outlet obstruction constipation. Br J Surg. 1999;86:355–9.

    Article  PubMed  CAS  Google Scholar 

  138. Dailianas A, Skandalis N, Rimikis MN, Koutsomanis D, Kardasi M, Archimandritis A. Pelvic floor study in patients with obstructive defecation: influence of biofeedback. J Clin Gastroenterol. 2000;30:176–80.

    Article  PubMed  CAS  Google Scholar 

  139. Gage H, Kaye J, Kimber A, et al. Correlates of constipation in people with Parkinson’s. Parkinsonism Relat Disord. 2011;17:106–11.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ronald F. Pfeiffer M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Pfeiffer, R.F. (2013). Intestinal Dysfunction in Parkinson’s Disease. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-429-6_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-429-6_10

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-428-9

  • Online ISBN: 978-1-60761-429-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics