Bowel and bladder disorders in Parkinson's disease

Area of Science:

• Neurology
• Gastroenterology
• Urology

Background:

• Bladder and gastrointestinal (GI) dysfunction are prevalent non-motor symptoms in Parkinson's disease (PD).
• These dysfunctions, affecting up to 70% of patients, often manifest before motor symptoms.
• Key GI issues include delayed gastric emptying and constipation, linked to myenteric plexus pathology.

Purpose of the Study:

• To highlight the commonality and characteristics of bladder and GI dysfunction in Parkinson's disease.
• To underscore the pathological underpinnings of these non-motor symptoms.
• To emphasize the clinical importance of managing these conditions.

Main Methods:

• Review of clinical features of GI dysfunction in PD.
• Analysis of pathological correlates, including myenteric plexus and central dopaminergic pathways.
• Discussion of clinical implications for patient care.

Main Results:

• Delayed gastric emptying and constipation are major GI issues in PD, affecting 70% of patients.
• Bladder dysfunction, specifically overactive bladder (OAB), also affects 70% of PD patients.
• GI dysfunction is associated with myenteric plexus pathology, while OAB relates to central dopaminergic pathway issues.

Conclusions:

• Bladder and GI dysfunction are significant non-motor aspects of Parkinson's disease.
• Understanding the underlying pathology is crucial for effective management.
• Proper management is essential to prevent complications like impaired levodopa absorption and intestinal pseudo-obstruction.