Management of dysphagia and gastroparesis in Parkinson's disease in real-world clinical practice - Balancing pharmacological and non-pharmacological approaches

Bhidayasiri, Roongroj and Phuenpathom, Warongporn and Tan, Ai Huey and Leta, Valentina and Phumphid, Saisamorn and Chaudhuri, K. Ray and Pal, Pramod Kumar (2022) Management of dysphagia and gastroparesis in Parkinson's disease in real-world clinical practice - Balancing pharmacological and non-pharmacological approaches. Frontiers in Aging Neuroscience, 14. ISSN 1663-4365, DOI https://doi.org/10.3389/fnagi.2022.979826.

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Abstract

Gastrointestinal (GI) issues are commonly experienced by patients with Parkinson's disease (PD). Those that affect the lower GI tract, such as constipation, are the most frequently reported GI problems among patients with PD. Upper GI issues, such as swallowing dysfunction (dysphagia) and delayed gastric emptying (gastroparesis), are also common in PD but are less well recognized by both patients and clinicians and, therefore, often overlooked. These GI issues may also be perceived by the healthcare team as less of a priority than management of PD motor symptoms. However, if left untreated, both dysphagia and gastroparesis can have a significant impact on the quality of life of patients with PD and on the effectiveness on oral PD medications, with negative consequences for motor control. Holistic management of PD should therefore include timely and effective management of upper GI issues by utilizing both non-pharmacological and pharmacological approaches. This dual approach is key as many pharmacological strategies have limited efficacy in this setting, so non-pharmacological approaches are often the best option. Although a multidisciplinary approach to the management of GI issues in PD is ideal, resource constraints may mean this is not always feasible. In `real-world' practice, neurologists and PD care teams often need to make initial assessments and treatment or referral recommendations for their patients with PD who are experiencing these problems. To provide guidance in these cases, this article reviews the published evidence for diagnostic and therapeutic management of dysphagia and gastroparesis, including recommendations for timely and appropriate referral to GI specialists when needed and guidance on the development of an effective management plan.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Parkinson's disease; Dysphagia; Gastroparesis; Diagnosis; Treatment; Multidisciplinary team; Pharmacological treatment; Non-pharmacological treatment
Subjects: R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 20 Sep 2023 03:08
Last Modified: 20 Sep 2023 03:08
URI: http://eprints.um.edu.my/id/eprint/41355

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