Journal Article

Management of Gastrointestinal Symptoms in Parkinson’s Disease

Lin, Chin-Hsien, Chiang, Han-Lin

2025

Overview

Gastrointestinal (GI) dysfunction is a common and often underappreciated aspect of Parkinson’s disease (PD), with symptoms manifesting at multiple levels of the digestive tract, from swallowing difficulties to challenges with defecation. These non-motor symptoms can be more debilitating than the hallmark motor impairments of PD, profoundly affecting patients’ quality of life. The burden of GI issues in PD extends beyond discomfort, contributing to malnutrition, weight loss, and impaired medication absorption, which can exacerbate both motor and non-motor symptoms. Despite their clinical significance, GI symptoms are frequently overlooked or mismanaged in routine practice. Inappropriate treatments, including certain medications and dietary recommendations, may inadvertently worsen the disease course. Therefore, a comprehensive understanding of GI dysfunction in PD is critical for clinicians, especially neurologists, to optimize patient care. This review provides an updated overview of the common GI manifestations in PD, including drooling, dyspepsia and dysphagia, gastroparesis, constipation, H. pylori infection, and small intestinal bacterial overgrowth. We discuss current diagnostic approaches, non-pharmacological and pharmacological treatment strategies. Recognizing and appropriately managing GI dysfunction in PD is essential for optimizing symptom control and improving patients’ overall well-being. Plain Language Summary Many people with Parkinson’s disease (PD) experience digestive problems, but these issues are often overlooked. Symptoms can affect the entire digestive system, from difficulty swallowing to trouble with bowel movements. In some cases, these problems can be more challenging than the movement difficulties caused by PD. Poor digestion can lead to malnutrition, weight loss, and problems absorbing medication, which may worsen both motor and non-motor symptoms. Unfortunately, digestive issues in PD are sometimes mismanaged, and certain treatments or dietary changes might make things worse. It is important for doctors to understand and properly address these symptoms. This article provides an updated overview of common digestive problems in PD, including drooling, difficulty swallowing, slow stomach emptying, constipation, and infections in the gut. It also discusses how these issues can be diagnosed and treated using both medical and non-medical approaches. Proper management of digestive problems can help improve the quality of life for people with PD.

• Publisher: SAGE Publications,Sage Publications Ltd,SAGE Publishing
• Subject: Constipation / Defecation / Drug therapy / Dyspepsia / Dysphagia / Gastrointestinal tract / Malnutrition / Movement disorders / Neurodegenerative diseases / Parkinson's disease / Patients / Quality of life / Review / Saliva / Small intestine / Swallowing