Gastrointestinal symptoms of Parkinson’s disease: A systematic review from pathogenesis to management

Abstract

The identification of Parkinson’s disease (PD) is mainly dependent on motor symptoms, while the non-motor symptoms exist even decades ahead of the PD diagnosis. According to Braak’s hypothesis, the enteric plexus is the first affected site during the pathological development of PD, and gastrointestinal (GI) symptoms appear during the onset of the disease. Although GI symptoms decrease the life quality of patients with PD, there is often less focus on GI symptoms compared with motor symptoms. In this review, we summarize the pathophysiological basis, clinical manifestation, diagnosis, and treatment of GI symptoms in patients with PD. We also discuss the treatment and research dilemmas, as well as the research direction in the near future.