He has participated in continuing medical education and educational activites on movement disorders (in the last 36 months) sponsored by PeerView, Prime, Quantia, Henry Stewart and by Vanderbilt University. He is an associate Editor for the New England Journal of Medicine Journal Watch Neurology. MS Okun has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients and Cambridge (movement disorder books). MS Okun has previously received honoraria, but in the past > 60 months has received no support from industry. MS Okun serves as a consultant for the National Parkinson foundation and has received grants from NIH, National Parkinson Foundation, the Michael J Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association and the University of Florida Foundation. Various prokinetics and laxatives are now available to provide some relief of the GI morbidity caused by PD leading even to better absorption of even the PD treatments. Our review is based on original papers or reviews selected from PUBMED search and Cochrane reviews.Įxpert opinion: Motility disorders of the GI tract are found frequently in patients with PD and treating the underlying GI disorders caused by PD with various prokinetics and laxatives is paramount in achieving improvements in patient’s motor function. Constipation occurs in the majority of patients with PD and fortunately many treatments are now available. Moreover, some commonly used medications can worsen pre-existing PD.Īreas covered: Our review will focus on treatment options for GP and SIBO with motilin agonists, dopamine receptor antagonists, Ghrelin agonists muscarinic agonists, 5-HT 4 receptor agonists, antibiotics, probiotics and herbal formulation such as iberogast. In particular, GP is difficult to treat due to the limited options available and precautions, contraindications and adverse effects associated with the approved treatments. Common GI disturbances in patients with PD include gastroparesis (GP), constipation and small intestinal bacterial overgrowth syndrome (SIBO). Introduction: Parkinson’s disease (PD) affects the nerves of the entire gastrointestinal (GI) tract and may result in profound gastrointestinal (GI) dysfunction leading to poor patient outcomes.
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