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

Doina Georgescu,1 Oana Elena Ancusa,1 Liviu Andrei Georgescu,2 Ioana Ionita,3 Daniela Reisz4 1Department of Internal Medicine, 2Department of Urology, 3Department of Hematology, 4Department of Neurology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Ab...

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Autores principales: Georgescu D, Ancusa OE, Georgescu LA, Ionita I, Reisz D
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Publicado: Dove Medical Press 2016
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spelling oai:doaj.org-article:e47b108f7bb042e0b2474171bdd87c1d2021-12-02T02:58:36ZNonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?1178-1998https://doaj.org/article/e47b108f7bb042e0b2474171bdd87c1d2016-11-01T00:00:00Zhttps://www.dovepress.com/nonmotor-gastrointestinal-disorders-in-older-patients-with-parkinsonrs-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Doina Georgescu,1 Oana Elena Ancusa,1 Liviu Andrei Georgescu,2 Ioana Ionita,3 Daniela Reisz4 1Department of Internal Medicine, 2Department of Urology, 3Department of Hematology, 4Department of Neurology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Abstract: 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. Keywords: PD, lower GI-NMS, probiotics, prokinetics, trimebutineGeorgescu DAncusa OEGeorgescu LAIonita IReisz DDove Medical PressarticleGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 1601-1608 (2016)
institution DOAJ
collection DOAJ
language EN
topic Geriatrics
RC952-954.6
spellingShingle Geriatrics
RC952-954.6
Georgescu D
Ancusa OE
Georgescu LA
Ionita I
Reisz D
Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: is there hope?
description Doina Georgescu,1 Oana Elena Ancusa,1 Liviu Andrei Georgescu,2 Ioana Ionita,3 Daniela Reisz4 1Department of Internal Medicine, 2Department of Urology, 3Department of Hematology, 4Department of Neurology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania Abstract: 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. Keywords: PD, lower GI-NMS, probiotics, prokinetics, trimebutine
format article
author Georgescu D
Ancusa OE
Georgescu LA
Ionita I
Reisz D
author_facet Georgescu D
Ancusa OE
Georgescu LA
Ionita I
Reisz D
author_sort Georgescu D
title 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_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_sort nonmotor gastrointestinal disorders in older patients with parkinson’s disease: is there hope?
publisher Dove Medical Press
publishDate 2016
url https://doaj.org/article/e47b108f7bb042e0b2474171bdd87c1d
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