Objective Colonic Dysfunction is Far more Prevalent than Subjective Constipation in Parkinson's Disease: A Colon Transit and Volume Study
Objective Colonic Dysfunction is Far more Prevalent than Subjective Constipation in Parkinson's Disease: A Colon Transit and Volume Study
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DOI：
10.3233/jpd-161050
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发表时间：
2017-01-01
影响因子：
5.2
通讯作者：
Borghammer, Per
中科院分区：
文献类型：
--
作者：
Knudsen, Karoline;Fedorova, Tatyana D.;Borghammer, Per
背景：在帕金森病（PD）的背景下，胃肠道功能越来越受到关注。便秘是最常见的非运动症状之一，但我们对潜在病理学的了解有限。主观便秘correlates poorly with objective marker.Objective：The aims were to evaluate colonic transmittance time and volume in PD and to correlate these measures with subjective symptoms and gastric emulsification.Methods：32例PD患者和26例对照者纳入研究。结肠通过时间、基于计算机断层扫描的容积估计和胃排空作为胃肠道功能的客观指标。主观胃肠道症状进行了评估，由三个不同的questionnaire.Results：79%的PD患者显示结肠传输时间延长（p < 0.0001）和66%的患者有显着增加结肠体积（p = 0.0002）。特别是横结肠和直肠乙状结肠段受到影响。组间胃排空时间无差异。PD患者的主观便秘的患病率显着降低，范围从3%至38%，取决于类型的questionnaire.Conclusions：显着延迟结肠传输时间和增加的体积是经常发现在PD患者，客观功能障碍是相当多的流行比主观便秘症状。此外，主观便秘的患病率变化很大，这取决于所采用的问卷。这些发现强调了需要更多的研究如何定义便秘在PD，也需要提高主观症状和客观功能障碍之间的关系的理解。
Background: Gastrointestinal function has received increased interest in the context of Parkinson's disease (PD). Constipation is among the most frequent non-motor symptoms, but our understanding of the underlying pathology is limited. Subjective constipation correlates poorly with objective markers.Objective: The aims were to evaluate colonic transit time and volume in PD and to correlate these measures with subjective symptoms and gastric emptying.Methods: Thirty-two PD patients and 26 controls were included. Colonic transit time, computed tomography-based volume estimation, and gastric emptying were performed as objective markers of gastrointestinal function. Subjective gastrointestinal symptoms were evaluated by three different questionnaires.Results: Seventy-nine percent of PD patients displayed prolonged colonic transit time (p < 0.0001) and 66% of patients had significantly increased colonic volume (p = 0.0002). Particularly the transverse and rectosigmoid segments were affected. There was no difference in gastric emptying time between groups. The prevalence of subjective constipation in PD patients was significantly lower and ranged from 3% to 38% depending on the type of questionnaire.Conclusions: Significantly delayed colonic transit time and increased volume were frequent findings in PD patients, and objective dysfunction was considerably more prevalent than subjective constipation symptoms. Also, the prevalence of subjective constipation varied widely depending upon which questionnaire was employed. These findings highlight the need for more research on how to define constipation in PD and also the need for improved understanding of the relationship between subjective symptoms and objective dysfunction.