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Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?

Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson’s disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females;...

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Autores principales: Georgescu, Doina, Ancusa, Oana Elena, Georgescu, Liviu Andrei, Ionita, Ioana, Reisz, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113937/
https://www.ncbi.nlm.nih.gov/pubmed/27956826
http://dx.doi.org/10.2147/CIA.S106284
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author Georgescu, Doina
Ancusa, Oana Elena
Georgescu, Liviu Andrei
Ionita, Ioana
Reisz, Daniela
author_facet Georgescu, Doina
Ancusa, Oana Elena
Georgescu, Liviu Andrei
Ionita, Ioana
Reisz, Daniela
author_sort Georgescu, Doina
collection PubMed
description Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson’s disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn–Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity. Laboratory studies, abdominal ultrasound, and upper and lower digestive endoscopies were performed to rule out organic issues. All patients increased their water intake to 2 L/d and alimentary fiber to 20–25 g/d. Twenty patients received trimebutine 200 mg three times daily half an hour before meals. The other 20 patients received probiotics (60 mg per-tablet of two lactic bacteria: Lactobacillus acidophilus and Bifidobacterium infantis), 2×/d, 1 hour after meals for 3 months along with the reassessment of GI complaints. Our results demonstrated that there were significant statistical differences in all assessed symptoms in the first group: 1.55±0.51 vs 0.6±0.5 (P<0.0001) for abdominal pain; 1.6±0.5 vs 0.45±0.51 (P<0.0001) for bloating; and 1.5±0.51 vs 0.85±0.67 (P=0.0014) for constipation with incomplete defecation. The second group displayed statistical differences only for abdominal pain 1.45±0.51 vs 1.05±0.69 (P=0.00432) and bloating 1.4±0.5 vs 0.3±0.47 (P<0.0001). For constipation with incomplete defecation, there was a slight improvement. Thus, there was no significant statistical difference: 1.35±0.49 vs 1.15±0.49 (P=0.2040). In conclusion, lower GI-NMS are frequently present, isolated or associated with other autonomic issues, even before the diagnosis of PD. Treatment with probiotics could improve abdominal pain and bloating as much as with trimebutine, but less for constipation with incomplete evacuation, where trimebutine showed better results.
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spelling pubmed-51139372016-12-12 Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope? Georgescu, Doina Ancusa, Oana Elena Georgescu, Liviu Andrei Ionita, Ioana Reisz, Daniela Clin Interv Aging Original Research Despite the fact that nonmotor symptoms (NMS) like gastrointestinal (GI) complaints are frequently reported in Parkinson’s disease (PD), no therapeutic guidelines are available. This study aimed to manage some lower GI-NMS in a group of patients with PD. A total of 40 patients (17 males, 23 females; mean age 76.05±2.09 years) were randomly selected for this study. Patients were confirmed to have PD (modified Hoehn–Yars scale: 2.075±0.4) who had undergone levodopa or dopamine agonist treatment. In the non-motor symptoms questionnaire (NMS-Quest), regarding GI complaints, the following were recorded: abdominal pain, bloating, and constipation of mild-to-moderate severity. Laboratory studies, abdominal ultrasound, and upper and lower digestive endoscopies were performed to rule out organic issues. All patients increased their water intake to 2 L/d and alimentary fiber to 20–25 g/d. Twenty patients received trimebutine 200 mg three times daily half an hour before meals. The other 20 patients received probiotics (60 mg per-tablet of two lactic bacteria: Lactobacillus acidophilus and Bifidobacterium infantis), 2×/d, 1 hour after meals for 3 months along with the reassessment of GI complaints. Our results demonstrated that there were significant statistical differences in all assessed symptoms in the first group: 1.55±0.51 vs 0.6±0.5 (P<0.0001) for abdominal pain; 1.6±0.5 vs 0.45±0.51 (P<0.0001) for bloating; and 1.5±0.51 vs 0.85±0.67 (P=0.0014) for constipation with incomplete defecation. The second group displayed statistical differences only for abdominal pain 1.45±0.51 vs 1.05±0.69 (P=0.00432) and bloating 1.4±0.5 vs 0.3±0.47 (P<0.0001). For constipation with incomplete defecation, there was a slight improvement. Thus, there was no significant statistical difference: 1.35±0.49 vs 1.15±0.49 (P=0.2040). In conclusion, lower GI-NMS are frequently present, isolated or associated with other autonomic issues, even before the diagnosis of PD. Treatment with probiotics could improve abdominal pain and bloating as much as with trimebutine, but less for constipation with incomplete evacuation, where trimebutine showed better results. Dove Medical Press 2016-11-11 /pmc/articles/PMC5113937/ /pubmed/27956826 http://dx.doi.org/10.2147/CIA.S106284 Text en © 2016 Georgescu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Original Research
Georgescu, Doina
Ancusa, Oana Elena
Georgescu, Liviu Andrei
Ionita, Ioana
Reisz, Daniela
Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title_full Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title_fullStr Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title_full_unstemmed Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title_short Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
title_sort nonmotor gastrointestinal disorders in older patients with parkinson’s disease: is there hope?
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113937/
https://www.ncbi.nlm.nih.gov/pubmed/27956826
http://dx.doi.org/10.2147/CIA.S106284
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