Bowel and bladder disorders in Parkinson's disease.
Bowel and bladder disorders in Parkinson's disease.
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Original abstract
Bladder and gastrointestinal (GI) dysfunction are one of the most common in non-motor disorder of Parkinson's disease (PD). GI dysfunction consists of delayed gastric emptying and constipation, which occur in 70 percent of patients and often predate motor disorder. Delayed gastric emptying, slow colonic transit, decreased phasic rectal contraction, weak abdominal strain and paradoxical sphincter contraction on defecation are all features of GI dysfunction in PD, reflecting mostly myenteric plexus pathology. Bladder dysfunction (overactive bladder [OAB]) occurs in 70 percent of patients. This reflects central pathology, particularly in the prefrontal-nigrostriatal DI dopaminergic pathways. The dysfunction needs particular care in order to prevent delayed absorption of levodopa and emergency intestinal pseudo-obstruction.