Abstract
Purpose of review
During the past 25 years, there has been an explosion of information regarding the occurrence of gastrointestinal dysfunction in Parkinson’s disease. In this review, the clinical features of gastrointestinal dysfunction in Parkinson’s disease will be described and information regarding the potential role of the enteric nervous system and the gut microbiome in the genesis of Parkinson’s disease will be addressed.
Recent findings
Recognition is growing regarding the role that gastroparesis and small intestinal dysfunction may play in Parkinson’s disease, especially with regard to erratic responses to anti-Parkinson medication. The presence of enteric nervous system involvement in Parkinson’s disease is now well established, but whether the enteric nervous system is the starting point for Parkinson’s disease pathology remains a source of debate. The potential role of the gut microbiome also is beginning to emerge.
Summary
Gastrointestinal dysfunction is a prominent nonmotor feature of Parkinson’s disease and dysfunction can be found along the entire length of the gastrointestinal tract. The enteric nervous system is clearly involved in Parkinson’s disease. Whether it is the initial source of pathology is still a source of controversy. There also is growing recognition of the role that the gut microbiome may play in Parkinson’s disease, but much more research is needed to fully assess this aspect of the disorder.
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References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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Dr. Pfeiffer reports grants from Acorda, personal fees from Lundbeck, personal fees from Cynapsus, personal fees from Clintara, personal fees from Adamas, other from Taylor & Francis (CRC Press), other from Springer (Humana Press), other from Elsevier, and outside the submitted work.
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Pfeiffer, R.F. Gastrointestinal Dysfunction in Parkinson’s Disease. Curr Treat Options Neurol 20, 54 (2018). https://doi.org/10.1007/s11940-018-0539-9
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DOI: https://doi.org/10.1007/s11940-018-0539-9