Stocchi Fabrizio, Torti Margherita
University and Institute for Research and Medical Care, IRCCS San Raffaele, Rome, Italy.
Int Rev Neurobiol. 2017;134:811-826. doi: 10.1016/bs.irn.2017.06.003. Epub 2017 Jul 13.
Constipation is one of the main and disabling nonmotor symptoms in Parkinson's disease (PD), with a prevalence ranging from 24.6% to 63% according to the different diagnostic criteria used to define chronic constipation. Constipation is currently recognized as a risk factor of PD in relation to the number of evacuation per week and its severity. Moreover, several studies have demonstrated that constipation may precede the occurrence of motor symptoms underlying an earlier involvement of the enteric nervous system and the dorsal motor nucleus of the vagus in the α-synuclein pathology. In PD, constipation is mainly due to slower colonic transit or puborectalis dyssynergia, but the concomitant use of antiparkinsonian, pain, and antidepressant medications may worsen it. An accurate diagnosis and an adequate treatment of constipation it is pivotal to prevent complications such as intestinal occlusion and to ensure an optimal clinical response to levodopa.
便秘是帕金森病（PD）主要的致残性非运动症状之一，根据用于定义慢性便秘的不同诊断标准，其患病率在24.6%至63%之间。就每周排便次数及其严重程度而言，便秘目前被认为是帕金森病的一个风险因素。此外，多项研究表明，便秘可能先于运动症状出现，这意味着肠神经系统和迷走神经背核在α-突触核蛋白病中更早受累。在帕金森病中，便秘主要是由于结肠传输减慢或耻骨直肠肌协同失调，但同时使用抗帕金森病药物、止痛药物和抗抑郁药物可能会使便秘加重。准确诊断和适当治疗便秘对于预防肠梗阻等并发症以及确保对左旋多巴的最佳临床反应至关重要。
