BERLIN -- Irritable bowel syndrome may be a more frequent symptom in Parkinson's disease than constipation, researchers reported here.
In a case-control study, about a quarter of Parkinson's patients had IBS compared with only 5% of healthy controls (P=0.001), according to , of the University of Helsinki, and colleagues.
On the other hand, the prevalence of constipation was higher among Parkinson's patients, but the difference from healthy controls wasn't significant, they reported at the .
"Gastrointestinal symptoms in Parkinson's disease are more complex than just constipation," Mertsalmi told 51˶. "Usually constipation is just seen as decrease bowel frequency, but it is also about straining during defecation, hard and lumpy stools, and diarrhea in these patients."
Previous work has shown that the majority of patients with Parkinson's suffer from gastrointestinal symptoms. About 70% have been estimated to have constipation, which is considered to be a premotor symptom of the disease and is one of the strongest risk factors for Parkinson's, Mertsalmi said.
IBS is among the most common functional gastrointestinal disorders, and is characterized by symptoms of abdominal pain or discomfort, and alteration of bowel habits.
Mertsalmi and colleagues suspected that some constipated Parkinson's patients might instead have a more complicated spectrum of bowel problems, particularly IBS. So they conducted a case-control study comparing 74 Parkinson's patients with 75 sex- and age-matched controls without the disease and without any symptoms of Parkinson's.
All patient with a pre-existing diagnosis of IBS were excluded, he added.
They examined four types of IBS: with constipation, diarrhea-dominant, mixed with both constipation and diarrhea, and unsubtyped.
Overall, they found IBS was significantly more prevalent in Parkinson's patients than in controls (24.3% versus 5.3%, P=0.001) -- but rates of constipation weren't significantly different between groups (12.2% versus 4%, P=0.072).
The two most common subtypes in Parkinson's patients were mixed IBS (14.9%) and constipation-predominant (6.8%), they reported.
Parkinson's patients with IBS also had a higher prevalence of other nonmotor symptoms than Parkinson' patients without IBS, but there was no difference between groups in terms of motor symptoms, Mertsalmi said.
When they looked at gut bacteria, they found a lower prevalence of Prevotella bacteria in IBS patients than in those without IBS, but Mertsalmi warned that their study can't determine the nature of the association.
He concluded that IBS, especially the IBS-mixed subtype, is common in Parkinson's patients, and that these patients may suffer from a broader spectrum of distal gastrointestinal symptoms in addition to constipation.
, of the National Parkinson's Foundation, who wasn't involved in the study, said it's important for physicians to understand the manifestations of constipation in Parkinson's disease.
"Gastrointestinal issues are a common cause of hospitalization, and when Parkinson's patients are admitted to the hospital for constipation their medications may be changed in a way their neurologist isn't aware of, and that can be detrimental to their Parkinson's symptoms."
"Anything we can do to keep patients out of the hospital is valuable," he said. "Addressing something that's an important acute symptom but not always recognized as part of Parkinson's care is valuable."
Disclosures
The authors disclosed no financial relationships with industry.
Primary Source
Movment Disorders Society
Mertsalmi T, et al "More than constipation – irritable bowel syndrome in Parkinson's disease" MDS 2016; Abstract 340.