Parkinson ’s Disease and Current Treatments for Its Gastrointestinal Neurogastromotility Effects

AbstractPurpose of ReviewGastrointestinal disturbances are seen in nearly all patients with Parkinson ’s disease and lead to impaired quality of life, affect drug pharmacodynamics, and potentially worsen patient’s existing motor fluctuations, leading to further disability. Recent evidence links abnormal accumulations of α-synuclein aggregates in the periphery (gut) as seen in the cortex which c auses dysfunctions impacting every level of the gastrointestinal tract from the esophagus, to the stomach, small bowel, colon, and rectum and can even predate the onset of the central neurologic disorder itself. Many treatments exist for the clinical phenotypes that result from the autonomic dysfunc tion and neuropathy involved in this neurodegenerative disorder.Recent findings/summaryThe treatments for the gut dysfunction seen in Parkinson ’s disease (PD) depend on the specific area of the gastrointestinal tract affected. For dysphagia, behavioral therapies with speech pathology, neuromuscular electrical stimulation, or botulinum toxin injection may be helpful. For gastroparesis, domperidone may serve as an antiemetic while also blu nting the hypotensive potential of Levodopa while new treatments such as ghrelin agonists may prove beneficial to help appetite, satiety, gastric emptying in those with constipation, and even improve constipation. Antibiotics such as rifaximin with poor systemic absorption may be used to treat small bacterial overgrowth also found in those with PD w...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research