GASTROINTESTINAL DYSFUNCTION IN PARKINSONS-DISEASE - A REPORT OF CLINICAL-EXPERIENCE AT A SINGLE-CENTER

We describe our clinical experience in the evaluation of gastrointesti nal symptoms in patients with Parkinson's disease. Dysphagia, heartbur n, medication-related nausea, and constipation were the predominant sy mptoms. Although all of the patients localized their dysphagia to the oropharynx and although oropharyngeal dysfunction was common, evaluati on revealed significant dysfunction in either the esophageal body or l ower esophageal sphincter in many-gastroesophageal reflux-related dise ase being especially common. Studies of anorectal sphincter and pelvic floor function in those patients with constipation demonstrated a hig h incidence of abnormal external anal sphincter dysfunction. We conclu de, first, that dysphagia in patients with Parkinson's disease should not be assumed to result solely from oropharyngeal dysfunction but des erves detailed evaluation and, second, that constipation in Parkinson' s disease is commonly consequent on anorectal sphincter and pelvic flo or dysfunction.