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J Anus Rectum Colon. 2019 Jan 29;3(1):10-17. doi: 10.23922/jarc.2018-022. eCollection 2019.

Lewy body constipation.

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Neurology, Internal Medicine, Sakura Medical Center, Toho University, Shimoshizu, Japan.
Pharmaceutical Unit, Sakura Medical Center, Toho University, Shimoshizu, Japan.
Department of Behavioral Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.


We systematically reviewed literature regarding "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. Because LBD significantly increases with age, "Lewy body constipation" may also increase with age. Neuroimaging methods such as metaiodobenzylguanidine (MIBG) scintigraphy and dopamine transporter (DAT) scan provide 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 required to ameliorate constipation in patients. Diagnosis is not always easy; therefore, collaboration of gastroenterologists and neurologists is highly recommended 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.


Lewy body constipation; Parkinson's disease; constipation; dementia with Lewy bodies; neuroimaging

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