Funding agencies: National Institute for Health Research Newcastle Biomedical Research Centre based at Newcastle Hospitals Foundation Trust and Newcastle University.
Delayed gastric emptying in Parkinson's disease
Article first published online: 21 OCT 2013
Copyright © 2013 Movement Disorder Society
Volume 29, Issue 1, pages 23–32, January 2014
How to Cite
Marrinan, S., Emmanuel, A. V. and Burn, D. J. (2014), Delayed gastric emptying in Parkinson's disease. Mov. Disord., 29: 23–32. doi: 10.1002/mds.25708
Relevant conflicts of interest/financial disclosures: Nothing to report.
Full financial disclosures and author roles may be found in the online version of this article.
- Issue published online: 23 JAN 2014
- Article first published online: 21 OCT 2013
- Manuscript Accepted: 3 SEP 2013
- Manuscript Revised: 30 JUL 2013
- Manuscript Received: 5 APR 2013
- Parkinson's disease;
- gastrointestinal motility;
- gastrointestinal hormones;
Gastrointestinal symptoms are evident in all stages of Parkinson's disease (PD). Most of the gastrointestinal abnormalities associated with PD are attributable to impaired motility. At the level of the stomach, this results in delayed gastric emptying. The etiology of delayed gastric emptying in PD is probably multifactorial but is at least partly related to Lewy pathology in the enteric nervous system and discrete brainstem nuclei. Delayed gastric emptying occurs in both early and advanced PD but is underdetected in routine clinical practice. Recognition of delayed gastric emptying is important because it can cause an array of upper gastrointestinal symptoms, but additionally it has important implications for the absorption and action of levodopa. Delayed gastric emptying contributes significantly to response fluctuations seen in people on long-term l-dopa therapy. Neurohormonal aspects of the brain-gut axis are pertinent to discussions regarding the pathophysiology of delayed gastric emptying in PD and are also hypothesized to contribute to the pathogenesis of PD itself. Ghrelin is a gastric-derived hormone with potential as a therapeutic agent for delayed gastric emptying and also as a novel neuroprotective agent in PD. Recent findings relating to ghrelin in the context of PD and gastric emptying are considered. This article highlights the pathological abnormalities that may account for delayed gastric emptying in PD. It also considers the wider relevance of abnormal gastric pathology to our current understanding of the etiology of PD. © 2013 International Parkinson and Movement Disorder Society