Lewy body constipation and Parkinson’s disease

Abstract

We described the current concept of ‘Lewy body constipation’, i.e., constipation due to Lewy body diseases (LBD), with minimal neurologic symptoms. Epidemiology and pathology studies showed that LBD can start with constipation alone, mostly due to neuronal loss and appearance of Lewy bodies in the myenteric plexus. Since LBD significantly increases with age, ‘Lewy body constipation’ may also increase with age. Neuroimaging such as metaiodobenzylguanidine (MIBG) scintigraphy and dopamine transporter (DAT) scan provides a way to detect ‘Lewy body constipation’. Key for ‘Lewy body constipation’ includes minimal non-motor features such as REM sleep behavior disorder (night talking). Add-on therapy may be needed to ameliorate constipation in the patients. Arriving at a diagnosis is not always easy. Therefore, collaboration of gastroenterologists and neurologists are highly recommended in order to maximize patients’ quality of life. In conclusion, ‘Lewy body constipation’ might become a distinct category among geriatric constipation, regarding patients follow-up and their management.