Gastrointestinal Manifestations in Parkinson's Disease Using a Validated Arabic Version of Gastrointestinal Dysfunction Scale: A Multicenter Study.

BACKGROUND

Gastrointestinal symptoms (GIS) contribute to the morbidity of Parkinson's disease (PD), with limited specific assessment tools.

OBJECTIVE

This multicenter study aimed to translate and validate the Gastrointestinal Dysfunction Scale for PD (GIDS-PD) into an Arabic version and to investigate the characteristics of GIS and its correlates.

METHODS

A total of 162 patients with PD and 165 age- and sex-matched healthy controls were assessed using the GIDS-PD. Arabic version was assessed for test-retest reliability, construct validity, convert validity, and floor or ceiling effects. Patients were assessed also using the International Parkinson and Movement Disorders Society-Unified Parkinson's Disease Rating Scale, Non-motor Symptoms Scale, and Parkinson's Disease Questionnaire-39.

RESULTS

The Arabic version of the GIDS-PD exhibited proper convergent validity, inter- and intrarater consistency, and an acceptable ceiling effect. Compared to controls, patients exhibited significantly higher frequency of all GIDS-PD items: difficulty in passing stools (86.42%), experiencing hard stools (65%), sensation of incomplete evacuation (75.93%), abdominal pain (69.14%), abnormal increase in passing stools (50.62%), abdominal distention (85.19%), involuntary weight loss (48.77%), difficulty in swallowing (64.81%), excessive salivation (68.52%), heartburn (82.10%), and nausea (43.83%). GISs were correlated to disease duration, motor and nonmotor severity, motor complications, and poorer quality of life (QoL). Predictors of the GIDS-PD included disease stage, motor severity, nonmotor burden, age, and dopaminergic daily dosage.

CONCLUSION

This multicenter study provided a validated Arabic version of GIDS-PD and demonstrated the high frequency of different GISs; their high correlation with motor severity, nonmotor burden, dopaminergic dosage, and age; and their negative impact on QoL, implying the importance of their assessment and management.