Objective: The objective was to describe the spectrum of gastrointestinal complaints in a large cohort of patients with advanced Parkinson’s Disease (APD), who were repeatedly evaluated to establish the opportunity of device aided therapy (DAT).

Background: Background: In addition to the motor complications that are inevitably associated with APD, there are a number of clinically diverse non-motor symptoms that crucially influence the quality of life of patients. Among these, gastrointestinal disorders are particularly important: they occur at all stages of the disease and adversely affect the pharmacokinetics of the levodopa treatment (LD).

Method: Methods: We retrospectively reviewed all patients with APD that were evaluated in our department between 1^st June 2011 and 31^st May 2017. Gastrointestinal symptoms were evaluated on the basis of questionnaires (yes-no responses). The following gastrointestinal complaints were queried: dysphagia, loss of appetite, epigastric discomfort, meteorism, early satiety, nausea, vomiting and constipation. The latter was defined according to the accepted criteria of the start of the study (2 stools or less per week).

Results: Results: Initially 311 patients were considered, eventually 286 patients with APD were fully evaluated (147 men, 139 women), with an average disease duration of 9.1±3.8 years (mean±SD). All patients had off periods with an average duration of 3.6±1.3 hours/day and 110 patients also had 2.7±0.9 hours/day dyskinesias. 181 patients had at least one gastrointestinal symptom accompanied by significantly greater disease duration, more severe clinical picture (longer off periods or more severe dyskinesia, higher Hoehn-Yahr score) and significantly higher doses of LD (both total daily dose and dosing frequency). Symptoms suggesting gastroparesis (dysphagia, loss of appetite, epigastric discomfort, meteorism, early satiety, nausea, vomiting) were, without exception, significantly more prevalent in patients with dyskinesia.

Conclusion: Conclusions: Although we are not aware if there is a clear correlation between the clinical signs suggesting gastroparesis and the existence of delayed gastric emptying with influence on LD pharmacokinetics, we consider that the early identification of gastrointestinal motility disorders with the purpose of delaying motor complications is of major importance.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/possible-correlations-between-symptoms-suggesting-gastroparesis-and-dyskinesias-in-advanced-parkinsons-disease/