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Gastrointestinal dysfunctions in Parkinson’s disease 

Gastrointestinal dysfunctions in Parkinson’s disease
Gastrointestinal dysfunctions in Parkinson’s disease
Non-motor Symptoms of Parkinson's Disease (2 ed.)

Fabrizio Stocchi

and Margherita Torti


Gastrointestinal dysfunctions and constipation are now recognized as symptoms of Parkinson’s disease (PD) and can even precede the motor symptoms. The Braak model for the pathodynamics of Lewy pathology in PD, with early involvement of the enteric nervous system and dorsal motor nucleus of the vagus, has led to the interpretation of the gastrointestinal symptoms as pre-motor manifestations of PD. Studies suggest gastrointestinal symptoms are one of the most common non-motor symptoms in PD patients. These symptoms and dysfunction not only are very distressing for the patients but interfere with treatment. The mobility and activities of daily living of parkinsonian patients depend on the blood level of levodopa. Levodopa is absorbed only from the small bowel (mostly in the duodenum, with some absorption in the jejunum and ileum). It has a short half-life, and therefore any factor which limits or delays levodopa absorption results in a reappearance of parkinsonian symptoms.

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