title: The treatment of gastroparesis, constipation and small intestinal bacterial overgrowth syndrome in patients with Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) affects the nerves of the entire gastrointestinal (GI) tract and may result in profound gastrointestinal (GI) dysfunction leading to poor patient outcomes. Common GI disturbances in patients with PD include gastroparesis (GP), constipation and small intestinal bacterial overgrowth syndrome (SIBO). In particular, GP is difficult to treat due to the limited options available and precautions, contraindications and adverse effects associated with the approved treatments. Moreover, some commonly used medications can worsen pre-existing PD.
  
  
  METHODS
  Our review will focus on treatment options for GP and SIBO with motilin agonists, dopamine receptor antagonists, Ghrelin agonists muscarinic agonists, 5-HT4 receptor agonists, antibiotics, probiotics and herbal formulation such as iberogast. Constipation occurs in the majority of patients with PD and fortunately many treatments are now available. Our review is based on original papers or reviews selected from PUBMED search and Cochrane reviews.
  
  
  CONCLUSIONS
  Motility disorders of the GI tract are found frequently in patients with PD and treating the underlying GI disorders caused by PD with various prokinetics and laxatives is paramount in achieving improvements in patient's motor function. Various prokinetics and laxatives are now available to provide some relief of the GI morbidity caused by PD leading even to better absorption of even the PD treatments.
authors.affiliation: a 1 University of South Florida , Tampa, FL, USA.
authors.forename: Jose L
authors.initials: JL
authors.lastname: Barboza
authors.affiliation: b 2 University of Florida, Center for Movement Disorders and Neurorestoration , Gainesville, FL, UK.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
authors.affiliation: c 3 University of Miami , Miami, FL, USA +1 30 5243 2515 , bmoshiree@med.miami.edu.
authors.forename: Baharak
authors.initials: B
authors.lastname: Moshiree
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001765:Blind Loop Syndrome / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D003248:Constipation / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D018492:Dopamine Antagonists / Q000627:therapeutic use; D018589:Gastroparesis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D018721:Muscarinic Agonists / Q000627:therapeutic use; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010936:Plant Extracts / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D058828:Serotonin 5-HT4 Receptor Agonists / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D018492:Dopamine Antagonists; D054368:Laxatives; D018721:Muscarinic Agonists; D010936:Plant Extracts; D058828:Serotonin 5-HT4 Receptor Agonists; C039964:iberogast
keywords: 5-HT4 receptor agonists; PEG; Parkinson’s disease; RM-131; STW5; TZP-101; TZP-102; autonomic nervous system dysfunction; azithromycin; constipation; domperidone; dysmotility; erythromycin; gastrointestinal; gastroparesis; iberogast; linaclotide; lubiprostone; mosapride; nizatidine; non-motor symptoms; probiotics; prucalopride; rifaximin; small intestinal bacterial overgrowth syndrome; ulimorelin