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Chapter 13 - Gastrointestinal Disturbances in Parkinson’s Disease Including the Management of Sialorrhea

Published online by Cambridge University Press:  05 March 2022

By
Wolfgang H. Jost  and
Lisa Klingelhoefer
Edited by
Néstor Gálvez-Jiménez ,
Amos D. Korczyn  and
Ramón Lugo-Sanchez
Néstor Gálvez-Jiménez
Affiliation:
Florida International University
Amos D. Korczyn
Affiliation:
Tel-Aviv University
Ramón Lugo-Sanchez
Affiliation:
Cleveland Clinic
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Summary

Gastrointestinal complaints are the most frequent autonomic symptoms in Parkinson’s disease (PD) and affect almost all patients over the course of time [1, 2, 3]. The causes are not clear. It is likely to be a multifactorial event in which both central and peripheral degenerative processes play a role [4, 5]. In addition, influences from the medication have to be considered, which are certainly not predominant. The central degenerative process involving the dorsal vagal nucleus is certainly significant, but it does not explain the range of symptoms. Involvement of the enteric nervous system is likely to be more crucial, with PD typical changes involving the presence of Lewy bodies extending from the upper esophagus down to the rectum in the Plexus myentericus Auerbach and the Plexus submucosus Meissner [4, 6, 7, 8, 9, 10]. The functional disturbance can therefore affect the entire gastrointestinal tract [5]. Thus dysphagia can occur in addition to delayed gastric emptying and extended intestinal transit.

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Chapter
Information
Non-motor Parkinson's Disease , pp. 145 - 154
Publisher: Cambridge University Press
Print publication year: 2022

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