Division of Gastroenterology, Digestive Disease Research Institute, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Mov Disord. 2014 Apr;7(1):7-12. doi: 10.14802/jmd.14002. Epub 2014 Apr 30.
Although 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.
Early 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.
Of 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.
Our findings confirm that gastrointestinal dysfunction occurs in early PD in relatively high frequency.
尽管胃肠道功能障碍在大多数帕金森病（PD）患者中发生，但由于许多患者在早期仍相对无症状，因此常常未被识别。我们使用新开发的胃肠道症状问卷调查了 PD 患者胃肠道症状的发生频率。
本研究纳入了症状持续时间不超过 3 年的早期 PD 患者。所有 PD 患者均使用包含三个相关领域的问卷进行评估：口咽食管（10 项）；胃（3 项）；和肠-肛门直肠（7 项）。通过计算每项得分≥2 的项目比例来计算症状的发生频率。
在纳入的 54 例患者中，48 例（88.9%）患者回答说肠症状在帕金森运动症状出现之前就已经出现，4 例患者报告说两种类型的症状（即肠和神经）同时出现，两者之间仅相隔数月。胃肠道症状的发生频率如下：言语障碍（40.7%）、流涎（24.1%）、哽噎感（31.5%）、窒息感（27.8%）、咽部异物感（16.7%）、重复吞咽（29.6%）、吞咽疼痛（5.6%）、食物反流（3.7%）、胃酸反流（7.4%）、恶心/呕吐（11.1%）、早饱（16.7%）、餐后饱胀（14.8%）、上腹痛（9.3%）、腹部疼痛（3.7%）、便秘（46.3%）、排便费力（33.3%）、粪便失禁（7.4%）、里急后重（20.4%）、稀便或腹泻（3.7%）和肛门括约肌难以放松（11.1%）。有 2 例患者得分为 0。
我们的研究结果证实，胃肠道功能障碍在早期 PD 中发生的频率相对较高。
