Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jan 5, 2021; 12(1): 21-31
Published online Jan 5, 2021. doi: 10.4292/wjgpt.v12.i1.21
Clinical features and relative factors of constipation in a cohort of Chinese patients with Parkinson's disease
Bai-Hua Sun, Tao Wang, Nian-Ying Li, Qiong Wu, Jin Qiao
Bai-Hua Sun, Nian-Ying Li, Department ofNeurology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Bai-Hua Sun, Department of Neurology, Xi'an Third Hospital, Xi'an 710021, Shaanxi Province, China
Tao Wang, Department ofNeurology, the Shaanxi Sengong Hospital, Xi'an 710300, Shaanxi Province, China
Qiong Wu, Jin Qiao, Department of Rehabilitation Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
Author contributions: Qiao J and Wu Q designed, organized, and supervised the study and revised the manuscript; Sun BH, Wang T, and Li NY completed the data collection; Sun BH performed the statistical analysis and article writing.
Supported by Key Research and Development Program of Shaanxi Province, China, No. 2018SF-016 and No. 2020SF-153.
Institutional review board statement: The study was reviewed and approved by the ethics committee of the First Affiliated Hospital of Xi'an Jiaotong University (No. XJTU1AF2019LSK-037 and No. XJTU1AF2020LSK-182).
Conflict-of-interest statement: The authors has no potential conflicts of interest to disclose.
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: Jin Qiao, MD, Professor, Department of Rehabilitation Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, No. 277 West Yanta Road, Xi'an 710061, Shaanxi Province, China. qiaojn123@163.com
Received: July 23, 2020
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
Processing time: 166 Days and 1.6 Hours
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

To investigate the prevalence and risk factors of constipation in a cohort study of Chinese patients with PD.

Research methods

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.

Research results

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).

Research conclusions

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.

Research perspectives

Constipation is a common symptom in PD patients and reduces their quality of life. It should attract more attention in the future studies.