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Most patients suffer from GIT symptoms, including dysphagia, sialorrhea, bloating, nausea, vomiting, gastroparesis, and constipation during the disease course. The underlying pathomechanisms of this \u03b1-synucleinopathy play an important role in disease development and progression, i.e., early accumulation of Lewy pathology in the enteric and central nervous systems is implicated in pharyngeal discoordination, esophageal and gastric motility\/peristalsis impairment, chronic pain, altered intestinal permeability and autonomic dysfunction of the colon, with subsequent constipation. Severe complications, including malnutrition, dehydration, insufficient drug effects, aspiration pneumonia, intestinal obstruction, and megacolon, frequently result in hospitalization. Sophisticated diagnostic tools are now available that permit more detailed examination of specific GIT impairment patterns. Furthermore, novel treatment approaches have been evaluated, although high-level evidence trials are often missing. Finally, the burgeoning literature devoted to the GIT microbiome reveals its importance for neurologists. We review current knowledge about GIT pathoanatomy, pathophysiology, diagnosis, and treatment in PD and provide recommendations for management in daily practice.<\/jats:p>","DOI":"10.1038\/s41531-022-00295-x","type":"journal-article","created":{"date-parts":[[2022,3,25]],"date-time":"2022-03-25T07:36:15Z","timestamp":1648193775000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":193,"title":["Gastrointestinal involvement in Parkinson\u2019s disease: pathophysiology, diagnosis, and management"],"prefix":"10.1038","volume":"8","author":[{"given":"T.","family":"Warnecke","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K-H.","family":"Sch\u00e4fer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Claus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Del Tredici","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8574-3297","authenticated-orcid":false,"given":"W. 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Radiographics 21, 1475\u20131490 (2001).","journal-title":"Radiographics"}],"container-title":["npj Parkinson's Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41531-022-00295-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41531-022-00295-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41531-022-00295-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,20]],"date-time":"2024-09-20T20:28:48Z","timestamp":1726864128000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41531-022-00295-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,24]]},"references-count":232,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["295"],"URL":"https:\/\/doi.org\/10.1038\/s41531-022-00295-x","relation":{},"ISSN":["2373-8057"],"issn-type":[{"value":"2373-8057","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,24]]},"assertion":[{"value":"29 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"K.-H.S., K.D.T., I.C., T.W., and W.J. declare no current or potential conflicts of interest. I.C. has previously received honoraria from Abbvie, BIAL, STADAPHARM, Georg Thieme Verlag KG, and consultancies from STADAPHARM. T.W. is an advisory board member of AbbVie, UCB, Archimedes, Phagenesis, Zambon, Bial, and Kyowa; he has received honoraria for lectures from Bial, AbbVie, STADA, UCB, Biogen, Licher, Desitin, Pfizer, Zambon, Teva, and Bayer; he also has received grants (investigator-initiated) from UCB, Licher, Abbvie, as well as academic grants from the G-BA Innovation Fund, Deutsche Parkinson-Vereinigung, (dPV), IZKF, and Neuro NRW (Germany). W.J. is a speaker and advisor for Abbie, Bial, Desitin, Licher, Stada, UCB, and Zambon.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"31"}}