Objective: To describe the prevalence of gastrointestinal manifestations in patients with Parkinson’s disease in a Brazilian movement disorders outpatient clinic and evaluate their associated factors and impact on quality of life.

Background: Parkinson’s disease (PD) is a neurodegenerative condition, with motor and non-motor manifestations. Among the non-motor symptoms, gastrointestinal phenomena are notable, impacting the patient’s clinical and pharmacological aspects.

Method: This is a cross-sectional study carried out in a Brazilian movement disorders outpatient clinic between October/2023 and February/2024. Patients ≥18 years of age with PD defined by UK Brain Bank criteria were analyzed. Demographic data, duration of illness and medication regimen were analyzed. The modified Hoehn&Yahr scale (mH&Y) was applied to analyze disease severity. The questionnaires used were the Rome III Criteria, to assess the presence of constipation, the Gastrointestinal Symptom Assessment Scale (GSRS) and the Parkinson’s Disease Questionnaire (PDQ-39).

Results: 40 patients were included, with a mean age of 61.4 years (±10.7) and a mean disease duration of 8 years (±4.6). Regarding the modified Hoehn & Yahr classification, 52.5% patients were between stages 2-4 (n = 21). Regarding the pharmacological profile, all patients were on levodopa therapy, with an average daily dose equivalent to 720 mg (± 269). 16 patients (40%) were taking medications for gastrointestinal symptoms, the most common being laxatives (n = 13; 32.5%). 28 patients (70%) met the Rome III criteria for the diagnosis of constipation. On the GSRS scale, the domain with the highest median score was constipation (12.5 [3.0-17.0]), followed by indigestion (10.0 [5.0-17.0]), abdominal pain (7.0 [3.0-9.0]) and reflux (3.0 [2.0-6.0]), with diarrhea being the lowest score (3.0 [3.0-8.0]). There was no significant difference in PDQ-39 scores between patients with constipation and those without constipation (45.9 vs 37.1, p= 0.224).

Conclusion: Gastrointestinal symptoms have a significant prevalence in our Brazilian patients, being related to the inclusion of gastrointestinal medications in the pharmacological regimen of some of them. In the study, the presence of constipation was not associated with a higher PDQ-39 score. Investigating these symptoms is important to guide better clinical management and change the perspective of patient care.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/beyond-constipation-gastrointestinal-phenomena-in-parkinsons-disease/