Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2021; 27(11): 1055-1063
Published online Mar 21, 2021. doi: 10.3748/wjg.v27.i11.1055
Study on the characteristics of intestinal motility of constipation in patients with Parkinson's disease
Mei Zhang, Shuang Yang, Xiao-Cui Li, Hong-Ming Zhu, Ding Peng, Bang-Yi Li, Tian-Xu Jia, Chen Tian
Mei Zhang, Shuang Yang, Xiao-Cui Li, Hong-Ming Zhu, Ding Peng, Bang-Yi Li, Tian-Xu Jia, Chen Tian, Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Mei Zhang, National Clinical Research Center for Geriatric Disease, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
Author contributions: Zhang M designed the research and wrote the paper; Yang S and Li XC performed the research; Li BY and Peng D analyzed the data; Jia TX and Tian C collected the data; all authors approved the final version.
Institutional review board statement: Institutional review board statement: This survey was reviewed and approved by the Ethics Committee of the Xuanwu Hospital of Capital Medical University.
Informed consent statement: The research subjects of this survey have fully understood and agreed to the research content.
Conflict-of-interest statement: The authors declare no conflict of interest regarding the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mei Zhang, PhD, Chief Physician, Doctor, Professor, Department of Gastroenterology, Xuanwu Hospital, Capital Medical University, No. 45 Changchun street, Xuanwu District, Beijing 100053, China. zhang2955@sina.com
Received: January 26, 2021
Peer-review started: January 26, 2021
First decision: February 8, 2021
Revised: February 14, 2021
Accepted: March 8, 2021
Article in press: March 8, 2021
Published online: March 21, 2021
Abstract
BACKGROUND

Constipation is one of the most important nonmotor symptoms in Parkinson's disease (PD) patients, and constipation of different severities is closely related to the pathogenesis of PD. PD with constipation (PDC) is considered a unique type of constipation, but its mechanism of formation and factors affecting its severity have been less reported. Understanding the gastrointestinal motility characteristics and constipation classification of PDC patients is essential to guide the treatment of PDC. In this study, the colonic transit test and high-resolution anorectal manometry were used to identify the intestinal motility of PDC to provide a basis for the treatment of PDC.

AIM

To investigate the clinical classification of PDC, to clarify its characteristics of colonic motility and rectal anal canal pressure, and to provide a basis for further research on the pathogenesis of PDC.

METHODS

Twenty PDC patients and 20 patients with functional constipation (FC) who were treated at Xuanwu Hospital of Capital Medical University from August 6, 2018 to December 2, 2019 were included. A colonic transit test and high-resolution anorectal manometry were performed to compare the differences in colonic transit time, rectal anal canal pressure, and constipation classification between the two groups.

RESULTS

There were no statistically significant differences in sex, age, body mass index, or duration of constipation between the two groups. It was found that more patients in the PDC group exhibited difficulty in defecating than in the FC group, and the difference was statistically significant. The rectal resting pressure, anal sphincter resting pressure, intrarectal pressure, and anal relaxation rate in the PDC group were significantly lower than those in the FC group. The proportion of paradoxical contractions in the PDC group was significantly higher than that in the FC group. There was a statistically significant difference in the type composition ratio of defecatory disorders between the two groups (P < 0.05). The left colonic transit time, rectosigmoid colonic transit time (RSCTT), and total colonic transit time were prolonged in PDC and FC patients compared to normal values. The patients with FC had a significantly longer right colonic transit time and a significantly shorter RSCTT than patients with PDC (P < 0.05). Mixed constipation predominated in PDC patients and FC patients, and no significant difference was observed.

CONCLUSION

Patients with PDC and FC have severe functional dysmotility of the colon and rectum, but there are certain differences in segmental colonic transit time and rectal anal canal pressure between the two groups.

Keywords: Parkinson's disease, Parkinson's disease with constipation, Colonic transit time, High-resolution anorectal manometry

Core Tip: In this study, we used the colonic transit test and rectal anal manometry to subtype constipation and detect corresponding indicators in patients with Parkinson's disease with constipation (PDC) and functional constipation, with the aim of clarifying the colonic and rectal motility characteristics of PDC and providing a basis for the treatment of PDC. It was found that the segmental colonic transit time and the constituent ratio of types of defecation disorders were statistically different between the two groups.