Clinical aspects of bowel symptoms in Parkinson's disease.
BACKGROUND
The clinical importance of bowel symptoms in Parkinson's disease (PD) remains to be described in detail.


METHODS
A 33-item questionnaire including background parameters, the Cleveland Constipation Score (CCS), and items from the Neurogenic Bowel Dysfunction score was sent to 468 PD patients. Results were compared to a control group (CG) (n = 45). A CCS of at least 15 was used to define severe constipation.


RESULTS
Four hundred and sixteen subjects (89%) responded. Median CSS was only 4 (range 0-21) in PD and 2 (range 0-13) in the CG (P < 0.05). Severe constipation was found in 7% with PD and 0% in the CG (P < 0.05). Incomplete emptying at defecation, need for assisted defecation and use of oral laxatives was reported more frequently by PD patients than by the CG (all P < 0.05). The severity of PD was associated with assisted defecation (P < 0.001), unsuccessful attempts at defecation (P < 0.001), incomplete emptying at defecation (P < 0.05), and the CCS (P < 0.01). Time since diagnosis was associated with infrequent defecation (P < 0.0001) and the CCS (P < 0.05). The use of levodopa was associated with less unsuccessful attempts at defecation (P < 0.05).


CONCLUSIONS
Most patients with PD only have minor constipation-related symptoms. However, severe constipation is associated with time since diagnosis and severity of disease.
Krogh
K
K
Neurogastroenterology Unit, Department of Hepatology and Gastroenterology V, Aarhus University Hospital, Aarhus, Denmark. krogh@as.aaa.dk
Ostergaard
K
K
Sabroe
S
S
Laurberg
S
S
D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology; D000978:Antiparkinson Agents / Q000627:therapeutic use; D017776:Autonomic Pathways / Q000503:physiopathology; D002490:Central Nervous System / Q000503:physiopathology; D015897:Comorbidity; D003248:Constipation / Q000453:epidemiology* / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D017615:Enteric Nervous System / Q000503:physiopathology; D005242:Fecal Incontinence / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D007422:Intestines / Q000294:innervation / Q000503:physiopathology*; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires
D000978:Antiparkinson Agents; D007980:Levodopa