Objective: We aimed to study objective markers of GI function (small intestinal- and colonic transit time, and colonic volume) in PD patients and healthy controls (HC) and correlate these measures to subjective GI symptoms.

Background: Most patients with Parkinson’s disease (PD) experience gastrointestinal (GI) symptoms, such as constipation. Despite constipation being one of the most prevalent non-motor symptoms, objective testing of the gastrointestinal tract is lacking.

Methods: Twenty-eight PD patients (early-to-moderate disease; 10 female) and 22 HC (9 female) have been included (recruitment is ongoing). Small intestinal transit time (STT) was estimated (11 PD, 10 HC) using the novel 3D-transit system (Motilis Medica SA, Lausanne, Switzerland); colonic transit time (CTT) was examined (13 PD, 11 HC) using radio opaque markers; colonic volume was defined on an abdominal CT scan. GI symptoms were evaluated using NMSQuest and ROME-III constipation questionnaires.

Results: The PD group displayed significantly increased STT (p=0.04) and CTT (p=0.01). Furthermore, four patients retained radio opaque markers in the small intestine. Significantly larger volumes were seen in transverse (p=0.008) and descending colonic segments (p=0.026) in PD. A near-significant correlation was seen between CTT and outlet symptoms (ie. straining) (p=0.058). No other significant correlations were found between objective measures and GI symptoms.

Conclusions: To our knowledge, this is one of the first studies of STT and colonic volume in PD. We demonstrated prolonged STT in most PD patients. Furthermore, transverse and descending colonic volume is significantly increased in PD. As previously reported, CTT in PD is also markedly increased. ROME and NMSQuest scores did not correlate with STT, CTT, or colonic volume, except for a near-significant correlation between straining and CTT. This potential mis-match between self-reported GI symptoms and objective measures suggests that objective GI investigations are necessary for correctly assessing the degree of GI dysfunction in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gastrointestinal-non-motor-symptoms-in-pd-correlation-between-objective-markers-and-subjective-symptoms/