Abnormal gastrointestinal function is relatively frequent inParkinson's disease, and constipation is a disturbing symptom in manypatients. However, it remains to be established whether anorectalabnormalities are characteristic of the late stages of the disease.Clinical and anorectal manometric function were investigated in groupsof early and late stage parkinsonian patients. Thirty one patients (19 men, 12 women, age range 22 to 89 years) entered the study. The diseaseseverity was assessed by Hoehn and Yahr staging: there were four(12.9%) stage I, seven (22.6%) stage II, 10 (32.2%) stage III, and10 (32.2%) stage IV patients. Anorectal variables were measured bystandard manometric equipment and techniques. Values obtained in earlystage patients (Hoehn and Yahr stage I and II) were compared with thoseobtained in late stage patients (Hoehn and Yahr stage III and IV).Overall, more than 70% of patients complained of chronic constipation, with chronic laxative use reported in more than 30%. Late stage patients were slightly older than their early stage counterparts. Pelvic floor dyssynergia was documented in more than 60% of patients. Manometric variables were not different in the two groups. In conclusion, defecatory dysfunction is frequent in Parkinson's disease,it is not confined to late stage patients, and it is found early in thecourse of the disease. This has potential implications for a targetedtherapeutic approach.
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