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Anal sphincter dysfunction in Parkinson's disease.

S E Mathers1, P A Kempster, P J Law

  • 1Department of Physiology, St Mark's Hospital, London, England.

Archives of Neurology
|October 1, 1989
PubMed
Summary
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Parkinson's disease can cause constipation due to paradoxical anal sphincter contraction. Dopamine agonists like apomorphine improved defecation in some patients, suggesting sphincter dysfunction is a key factor.

Area of Science:

  • Neuroscience
  • Gastroenterology
  • Clinical Medicine

Background:

  • Chronic constipation is a common issue in Parkinson's disease.
  • Anal sphincter dysfunction may contribute to constipation in parkinsonian patients.

Purpose of the Study:

  • To investigate the electrophysiological and radiological function of the striated anal sphincter in Parkinson's disease patients with chronic constipation.
  • To assess the effect of apomorphine on defecatory mechanisms.

Main Methods:

  • Electrophysiological and radiological studies of the striated anal sphincter.
  • Administration of the dopamine receptor agonist apomorphine.
  • Assessment of simulated defecation straining.

Main Results:

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  • Five out of six patients exhibited paradoxical anal sphincter contraction during straining, indicative of anismus.
  • Radiological studies showed improved defecatory mechanisms in four patients after apomorphine administration.

Conclusions:

  • Striated anal sphincter dysfunction is a potential cause of constipation in Parkinson's disease patients.
  • This dysfunction may be part of the generalized extrapyramidal motor disorder associated with Parkinson's.
  • Dopamine agonists show promise in improving defecatory function in affected individuals.