P3655 - Gastrointestinal Symptoms Preceding Parkinson’s Disease Onset and Associated Outcomes

Kimberly Ho, MD¹, Abraham Z. Cheloff, MD, MS², Jeena Khan, BA³, Ashish Malhotra, MD², Aasma Shaukat, MD, MPH^2
1Brown University / Rhode Island Hospital, Providence, RI; ²NYU Langone Health, New York, NY; ³Royal College of Surgeons in Ireland, New York, NY

Introduction: Gastrointestinal (GI) symptoms, including constipation are some of the most prevalent symptoms before and after Parkinson’s disease (PD) diagnosis. GI symptoms have been found to be an early marker for cognitive impairment and dementia and could indicate rapidly progressive PD. The aim of this systematic review and meta-analysis is to assess the prevalence, incidence, and outcomes of patients with and without gastrointestinal symptoms such as constipation and how it may correlate with Parkinson’s onset and severity.

Methods: The PICOT question used for the systematic review was: Population (P) – patients with PD, Intervention (I) – constipation or GI symptoms, Comparator (C) – PD patients without GI symptoms, Outcome (O) – progression and severity of PD, Time (T) – over 5 years. A comprehensive search of electronic databases, including Ovid MEDLINE(R) from 1946 to 2023 and Embase from 1974 to 2024, was done. We included studies of any design reporting constipation, gastrointestinal dysmotility, or gastrointestinal non-motors symptoms and mortality, morbidity, prognosis, and rate of decline in patients with Parkinson’s disease.

Results: 27 articles were included for the systematic review. 5 studies reported GI symptoms (i.e., constipation, dysphagia, increased salivation) concomitantly with PD, and the pooled prevalence was 75.5%. 5 studies reported GI symptoms proceeding PD diagnosis, and the incidence was 55.9%. 3 studies reported constipation concomitantly with PD, and the pooled prevalence was 26.7%. 3 studies reported constipation proceeding PD diagnosis, and the incidence was 72.7%. 9 studies also reported dementia in patients with GI symptoms at the time of PD. The rate of dementia is higher among patients presenting with GI symptoms and PD than PD alone, which is reported 20 to 40%.

Discussion: Prevalence of GI symptoms preceding PD was 75.5% while the incidence of GI symptoms in patients with PD was 55.9%. In patients with PD and GI symptoms, the risk of dementia or progression was higher than in those with PD alone. More research is still needed to characterize to what extent GI symptoms correlate with PD mental and cognitive functions.



Disclosures:


Kimberly Ho, MD¹, Abraham Z. Cheloff, MD, MS², Jeena Khan, BA³, Ashish Malhotra, MD², Aasma Shaukat, MD, MPH². P3655 - Gastrointestinal Symptoms Preceding Parkinson’s Disease Onset and Associated Outcomes, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.