The Prevalence of Constipation and Irritable Bowel Syndrome in Parkinson’s Disease Patients According to Rome III Diagnostic Criteria

Abstract

Background: Gastrointestinal symptoms are one of the most common non-motor features of Parkinson’s disease (PD). Recently, a report from Taiwan revealed that irritable bowel syndrome (IBS) may be associated with an increased risk of developing PD; however, the prevalence of IBS in PD patients has not been fully evaluated. Rome III criteria are widely assessed with a questionnaire to determine functional gastrointestinal disorders.Objective: We assessed the prevalence of constipation and IBS in PD patients in our cohort using Rome III criteria.Methods: Between October 2014 and April 2015, 118 patients with PD were treated at Fukuoka University Hospital and were enrolled in this study. Rome III criteria were used to diagnose constipation and IBS.Results: Constipation and IBS were detected in 32 (27.1%) and 20 patients (17.0%), respectively. The most common symptom related to constipation was straining during defecation (77.1%). Among constipation symptoms, patients’ self-awareness of constipation was mostly related to straining during defecation (odds ratio 5.27, 95% confidence interval 1.475–18.811). The number of constipation symptoms was correlated with the severity of the Hoehn-Yahr Stage (p < 0.05) and total levodopa equivalent dose (p < 0.05).Conclusions: This is the first report to investigate the prevalence of IBS in PD patients with Rome III criteria. We found a higher prevalence of IBS compared with the general population. The prevalence of constipation based on Rome III criteria was much lower than that reported in previous studies. Further studies are warranted to evaluate gastrointestinal symptoms in PD patients using comparable questionnaires.

Stool Immune Profiles Evince Gastrointestinal Inflammation in Parkinson's Disease

“…Our study also corroborates the few reports of associations between PD and intestinal disease, with significantly more PD patients than controls in our cohort reporting a history of inflammatory bowel disease, irritable bowel syndrome, Crohn's disease, and/or colitis. The mechanisms responsible for this epidemiological overlap have not been determined.…”

“…In keeping with the well‐known connections between inflammatory stimuli and impairment of gut barrier function, intestinal permeability in PD correlates with levels of αSYN as well as indicators of oxidative stress . In addition, recent studies have reported significant coincidence of IBD or irritable bowel syndrome and PD . One study reported the most direct confirmation of intestinal inflammation in PD, finding increases in mRNA transcripts encoding 4 proinflammatory cytokines (tumor necrosis factor, interferon gamma, interleukin‐6, and interleukin‐1β) as well as 3 glial markers in colonic biopsies of PD patients compared with age‐matched healthy controls …”

“…18 In addition, recent studies have reported significant coincidence of IBD or irritable bowel syndrome and PD. [32][33][34] One study reported the most direct confirmation of intestinal inflammation in PD, finding increases in mRNA transcripts encoding 4 proinflammatory cytokines (tumor necrosis factor, interferon gamma, interleukin-6, and interleukin-1b) as well as 3 glial markers in colonic biopsies of PD patients compared with age-matched healthy controls. 35 Given the accumulation of evidence suggesting that pronounced GI dysfunction and dysbiosis occur in PD, we conducted an extensive analysis of immune and angiogenesis factors in stool to assess the GI inflammatory state in PD patients, their healthy spouses, and unrelated healthy control subjects.…”

More than constipation – bowel symptoms in Parkinson's disease and their connection to gut microbiota

“…According to Rome III criteria, 36.5% of PD patients fulfilled the criteria for IBS or FC, but in this group IBS+ was actually more prevalent than FC. A recent Japanese study reported IBS criteria to be fulfilled in 17.0% and FC in 27.1% of PD patients . Moreover, 58.1% of PD patients in our study had symptoms of diarrhoea.…”

Gut Vibes in Parkinson's Disease: The Microbiota‐Gut‐Brain Axis

“…Based on this hypothesis, it has been suggested that αSyn aggregates may potentially spread from the gut (ENS) to the brain (CNS) as a prion‐like protein by cell‐to‐cell transfer . These assumptions seem to be consistent with the long‐reported nonmotor symptoms of PD patients, often occurring before the onset of motor symptoms, including olfactory impairment and gastrointestinal (GI) dysfunctions, such as constipation and colonic inflammation …”