Mishima Takayasu, Fukae Jiro, Fujioka Shinsuke, Inoue Kotoe, Tsuboi Yoshio
J Parkinsons Dis. 2017;7(2):353-357. doi: 10.3233/JPD-160982.
Gastrointestinal symptoms are one of the most common non-motor features of Parkinson's disease (PD). Recently, a report from Taiwan revealed that irritable bowel syndrome (IBS) may be associated with an increased risk of developing PD; however, the prevalence of IBS in PD patients has not been fully evaluated. Rome III criteria are widely assessed with a questionnaire to determine functional gastrointestinal disorders.
We assessed the prevalence of constipation and IBS in PD patients in our cohort using Rome III criteria.
Between October 2014 and April 2015, 118 patients with PD were treated at Fukuoka University Hospital and were enrolled in this study. Rome III criteria were used to diagnose constipation and IBS.
Constipation and IBS were detected in 32 (27.1%) and 20 patients (17.0%), respectively. The most common symptom related to constipation was straining during defecation (77.1%). Among constipation symptoms, patients' self-awareness of constipation was mostly related to straining during defecation (odds ratio 5.27, 95% confidence interval 1.475-18.811). The number of constipation symptoms was correlated with the severity of the Hoehn-Yahr Stage (p < 0.05) and total levodopa equivalent dose (p < 0.05).
This is the first report to investigate the prevalence of IBS in PD patients with Rome III criteria. We found a higher prevalence of IBS compared with the general population. The prevalence of constipation based on Rome III criteria was much lower than that reported in previous studies. Further studies are warranted to evaluate gastrointestinal symptoms in PD patients using comparable questionnaires.
胃肠道症状是帕金森病(PD)最常见的非运动症状之一。最近,台湾的一份报告显示,肠易激综合征(IBS)可能与患PD的风险增加有关;然而,PD患者中IBS的患病率尚未得到充分评估。罗马Ⅲ标准通过问卷广泛用于确定功能性胃肠疾病。
我们使用罗马Ⅲ标准评估了我们队列中PD患者便秘和IBS的患病率。
2014年10月至2015年4月期间,118例PD患者在福冈大学医院接受治疗并纳入本研究。采用罗马Ⅲ标准诊断便秘和IBS。
分别在32例(27.1%)和20例患者(17.0%)中检测到便秘和IBS。与便秘相关的最常见症状是排便时用力(77.1%)。在便秘症状中,患者对便秘的自我认知主要与排便时用力有关(优势比5.27,95%置信区间1.475 - 18.811)。便秘症状的数量与Hoehn - Yahr分期的严重程度(p<0.05)和左旋多巴等效总剂量(p<0.05)相关。
这是第一份使用罗马Ⅲ标准调查PD患者中IBS患病率的报告。我们发现IBS的患病率高于一般人群。基于罗马Ⅲ标准的便秘患病率远低于先前研究报告的患病率。有必要进行进一步研究,使用可比问卷评估PD患者的胃肠道症状。