101MANAGEMENT OF CONSTIPATION IN PARKINSON’S DISEASE: A SYSTEMATIC REVIEW

Abstract

Introduction: Constipation is one of the earliest and most common non-motor symptoms experienced by patients with Parkinson's Disease (PD). There are currently no clear guidelines to help clinicians manage constipation in patients with PD. This systematic review aimed to examine the literature in this area to determine what treatment options are efficacious and could be recommended for use in clinical practice. Methods: Electronic searches were performed in Medline® and Embase (1974-Dec 2017). Relevant abstracts were identified based on pre-determined inclusion and exclusion criteria. The full text of shortlisted abstracts was then reviewed. Studies with participants with idiopathic PD diagnosed clinically or using formal research criteria were included. No restriction was made on the ground of participant's age, gender, ethnicity or disease duration. All studies that looked into the management of constipation in PD were included. Consideration was given to all reported outcome measures for constipation. Results: 27 studies were included in the final analysis. From the 27 eligible studies, 21 different proposed interventions were analysed. The outcome measures used to determine participants' responses to interventions were just as varied as the interventions proposed. The heterogeneity of the outcome measures made quantitative data extraction impossible. The majority of the included studies were of poor quality - small sample sizes with flawed study methodology. Conclusion: Insufficient evidence was found to recommend any treatment option for the management of constipation in PD. This is most likely due to the poor research methodologies used. The lack of standardised outcome measures made comparisons between different studies results challenging. Recommendations are made to ensure good quality studies can be conducted in the future.