Published online Jan 5, 2021. doi: 10.4292/wjgpt.v12.i1.21
Peer-review started: July 23, 2020
First decision: September 24, 2020
Revised: September 28, 2020
Accepted: November 5, 2020
Article in press: November 5, 2020
Published online: January 5, 2021
Parkinson's disease (PD) is a neurodegenerative disorder and causes motor symptoms including resting tremor, akinesia, and rigidity. Recently, the focus of clinical research on PD is shifting to non-motor symptoms (NMS). Among all NMS, constipation is particularly common, but the reason why PD patients are prone to constipation is still unclear. In addition to physical weakness and other factors, lifestyles and eating habits are important factors as well. The prevalence and influencing factors of constipation may vary among different populations.
At present, the mechanisms and risk factors underlying constipation in patients with PD are still uncertain. Although the prevalence of constipation in Chinese patients with PD has been reported before, it may vary among different populations due to the different lifestyles and eating habits. Therefore, we need to understand the prevalence and influencing factors of constipation in the PD population in northwest China.
To investigate the prevalence and risk factors of constipation in a cohort study of Chinese patients with PD.
Based on accepted diagnostic criteria and a series of clinic rating scales, which contained modified Hoehn-Yahr stage, Unified PD Rating Scale (UPDRS) III, non-motor symptoms assessment scale (NMSS), Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA), Parkinson’s disease Questionnaire-39 (PDQ-39), Montreal cognitive assessment, etc. The incidence and related factors of constipation was identified based on a retrospective survey. All subjects were recruited from March to November 2018 at the Department of Neurology of the First Affiliated Hospital of Xi'an Jiaotong University. In the following statistical analyses, t-test, spearman correlation, nonparametric test, one-way ANOVA, and unconditional logistic regression analysis were used.
In this study, 52.41% of patients were accompanied with constipation, and 34.48% had constipation occurring 6.30 ± 5.06 years before the onset of motor symptoms. The age of patients, disease duration, Hoehn-Yahr stage, duration of levodopa treatment, incidence of motor complications, scores of UPDRS total and UPDRS III, NMSS, HAMD, HAMA, and PDQ-39 in the constipation group were significantly higher than those in the non-constipation group (P < 0.05). Compared to the non-constipation group, there was a higher incidence of depression in patients with constipation (46.84% vs 64.37%, P < 0.05). The logistic regression analysis demonstrated that only NMSS score was an independent risk factor for constipation (P < 0.001).
Our findings confirm that constipation has a relatively high frequency in patients with PD. PD patients with constipation have a higher incidence of depression, which leads to worse quality of life.
Constipation is a common symptom in PD patients and reduces their quality of life. It should attract more attention in the future studies.