LAUSR

Gastrointestinal involvement in Parkinson ’ s disease (PD) can impact quality of life through disabling symptoms including nausea, early satiety, anorexia, and constipation and via disruption of oral levodopa absorption and motor and nonmotor fl uctuations. 1 – 3 Impaired gastric emptying (GE) may cause dose failures, delayed drug effect (delayed on ) and hence unpredictable dose responses. 4,5 We report 2 patients with PD with striking examples of documented severe, prolonged upper gastrointestinal dysmotility to highlight this problem. gastroparesis, a more prolonged pre-endos-copy fasting period may be a practical step to avoid encountering food residue and hence procedure abandonment. Although domp-eridone may be an effective prokinetic agent in PD, 10 its long-term use is not recommended because of the potential adverse cardiac conduction effects. Cisapride and prucalopride, selective 5-HT4 receptor agonists, have been shown in small, open-label studies to improve GE in PD without cardiac adverse effects. 11 – 14 We advocate close attention to gastrointestinal motility strategies in PD, including consideration of oral prokinetic agents, dietary modi fi cations, and