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:
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.
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
Processing time: 49 Days and 20.6 Hours
Research background

Parkinson's disease (PD) is a common neurodegenerative disease characterized clinically by typical motor symptoms such as tremor, bradykinesia and myotonia and non motor symptoms such as constipation, depression and dysmetria. Constipation is one of the most common clinical manifestations of PD patients. Investigations have shown that the incidence of constipation among PD patients is up to 88%, and constipation is regarded as one of the independent risk factors for PD. PD constipation (PDC) is considered a unique type of constipation that is clinically inadequately treated, severely affecting patient quality of life. Current studies on the characteristics of intestinal motility in patients with Parkinson's disease with constipation are less frequently reported, and the control groups are mostly healthy subjects, and the conclusions are not uniform.

Research motivation

It is likely that there is a causal relationship between PD and constipation, such that they exacerbate one another and form a vicious cycle. However, PDC treatment is very difficult and prone to drug resistance. Compared with functional constipation, it is not clear whether the clinical characteristics and influencing factors of PDC are unique. Understanding the gastrointestinal motility characteristics and constipation classification of PDC patients is essential to guide the treatment of PDC.

Research objectives

To identify the gastrointestinal motility of PDC and provide a basis for its treatment. Moreover, to find more sensitive and specific indicators to predict which constipation patients will eventually develop PD.

Research methods

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 Patients with PDC and functional constipation (FC).

Research results

The study found that 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. The different segments of the colonic transit test (CTT) were also significantly different. The rectosigmoid colonic transit time of PDC patients was significantly longer than that of FC patients, and the right colonic transit time was significantly shorter.

Research conclusions

Cases of PDC and FC were associated with a prolonged CTT and abnormal high-resolution anorectal manometry. There are certain differences in segmental colonic transit time, rectal anal canal pressure and composition type ratio of defecatory disorders between the two groups.

Research perspectives

This study can be helpful for further studies of the mechanism of PDC and FC and for early diagnosis and treatment of patients with PD.