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Aktuelle Neurologie 2009; 36: S299-S305
DOI: 10.1055/s-0029-1220456
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Der Gastrointestinaltrakt in der Parkinson-Therapie

The Gastrointestinal Tract in the Therapy of Parkinson's DiseaseD.  Woitalla1 , O.  Götze2
  • 1Neurologische Klinik der Ruhr-Universität Bochum
  • 2Universitätshospital Zürich
Further Information

Publication History

Publication Date:
21 October 2009 (online)

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Zusammenfassung

Gastrointestinale Funktionsstörungen sind das häufigste nicht motorische Symptom der Parkinson-Erkrankung und können den motorischen Symptomen vorausgehen. In den Krankheitsprozess sind nahezu alle Abschnitte des Magen-Darm-Trakts einbezogen. Neben dem Einfluss auf die Lebensqualität der Patienten hat die gastrointestinale Dysfunktion auch für die Therapie der Parkinson-Erkrankung erhebliche Bedeutung. Da die meisten Parkinson-Medikamente oral verabreicht werden, führen Störungen der Magenentleerung zu einer signifikanten Verzögerung der enteralen Resorption. Die irreguläre Pharmakokinetik oral verabreichter Medikamente, insbesondere von L-Dopa, erklärt die meisten der unerwarteten motorischen Fluktuationen fortgeschrittener Parkinson-Patienten. Eine Behandlung dieser Therapiekomplikationen sollte diesen Zusammenhang berücksichtigen.

Abstract

Gastrointestinal dysfunction is a common symptom in Parkinson's disease and the most common non-motor feature. The gastrointestinal dysfunction may precede the motor symptoms of the disease. The disease involves virtually all parts of the digestive tract. Beside the alterations of quality of life in most patients, gastrointestinal dysfunction has significant implications for the treatment of the disease. While most drugs in the therapy for Parkinson's disease are orally administered, disturbances in gastric emptying can cause significant delays in enteric resorption. The irregular pharmakokinetic behaviour of orally administered drugs, especially levodopa, may explain most of the unexpected motor fluctuations, seen in advanced stages of the disease. The treatment of motor fluctuations should therefore consider disturbances in gastric and enteric motility.

Schlüsselwörter

idiopathisches Parkinson-Syndrom - Gastrointestinaltrakt - Frühsymptom - Magenentleerungsstörung

Keywords

idiopathic Parkinson's syndrome - gastrointestinal tract - early symptoms - delayed gastric emptying

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PD Dr. Dirk Woitalla

Neurologische Klinik der Ruhr-Universität Bochum

Gudrunstr. 56

44791 Bochum

Email: Dirk.Woitalla@rub.de