Gastric Dysfunction in Parkinson's Disease

Parkinson's disease (PD) is a degenerative illness affecting the central, autonomic, and the enteric nervous systems (ENS). Neuropathological changes have been described in all parts of the ENS in PD patients. Gastric dysfunction is common in PD patients and includes delayed gastric emptying (gastroparesis), early satiety, anorexia, abdominal fullness, nausea, and vomiting. Gastric dysfunction may impair drug absorption and thus contribute to motor fluctuations in PD. Moreover, antiparkinsonian medications themselves may exacerbate gastric dysfunction. To date, there is no satisfactory drug treatment for gastroparesis, and the clinician will need considerable creativity for planning therapeutic management to help the PD patient overcome this disabling syndrome and its consequences. Dietetic interventions, together with prokinetic medications, are recommended. Gastrostomy or jejunostomy feeding tubes should also be considered for patients with severe gastroparesis.