Byrne K G, Pfeiffer R, Quigley E M
Department of Internal Medicine, University of Nebraska Medical Center, Omaha.
J Clin Gastroenterol. 1994 Jul;19(1):11-6. doi: 10.1097/00004836-199407000-00004.
We describe our clinical experience in the evaluation of gastrointestinal symptoms in patients with Parkinson's disease. Dysphagia, heartburn, medication-related nausea, and constipation were the predominant symptoms. Although all of the patients localized their dysphagia to the oropharynx and although oropharyngeal dysfunction was common, evaluation revealed significant dysfunction in either the esophageal body or lower esophageal sphincter in many--gastroesophageal reflux-related disease being especially common. Studies of anorectal sphincter and pelvic floor function in those patients with constipation demonstrated a high incidence of abnormal external anal sphincter dysfunction. We conclude, first, that dysphagia in patients with Parkinson's disease should not be assumed to result solely from oropharyngeal dysfunction but deserves detailed evaluation and, second, that constipation in Parkinson's disease is commonly consequent on anorectal sphincter and pelvic floor dysfunction.
我们描述了在评估帕金森病患者胃肠道症状方面的临床经验。吞咽困难、烧心、药物相关性恶心和便秘是主要症状。尽管所有患者都将吞咽困难定位于口咽部，且口咽功能障碍很常见，但评估发现许多患者的食管体部或食管下括约肌存在明显功能障碍，胃食管反流相关疾病尤为常见。对那些便秘患者的肛门直肠括约肌和盆底功能研究表明，肛门外括约肌功能异常的发生率很高。我们得出结论，首先，帕金森病患者的吞咽困难不应被认为仅由口咽功能障碍引起，而值得进行详细评估；其次，帕金森病中的便秘通常是由肛门直肠括约肌和盆底功能障碍所致。
