Artículo
Management of constipation in Parkinson’s disease
Registro en:
1465-6566
1744-7666 (online)
10.1517/14656566.2015.997211
25539892
Autor
Rossi, Marcelo
Merello, Marcelo
Pérez Lloret, Santiago
Institución
Resumen
Abstract Introduction: Constipation is a frequent non-motor feature of Parkinson’s disease
(PD). It is the most common gastrointestinal symptom of the disease and
it can precede motor symptoms by as much as 20 years. Constipation can produce
discomfort and affect activities of daily living, productivity and quality of
life, thus warranting early diagnosis and treatment.
Areas covered: In this review, the safety and efficacy of traditional and novel
strategies for constipation management will be discussed. A treatment algorithm
for constipation in PD will be presented.
Expert opinion: Polyethylene glycol and lubiprostone are first-line compounds
recommended by evidence-based medicine guidelines for the treatment
of constipation due to slow colonic transit in PD. Management of
constipation secondary to defecatory dysfunction due to pelvic floor dyssynergia
can be done by levodopa or apomorphine injections, botulinum toxin
type A injection into the puborectalis muscle, and nonpharmacological interventions,
like biofeedback therapy or functional magnetic stimulation, which
showed some benefit in PD patients with constipation, but in general more
extensive studies are warranted.