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Perdiem causing esophageal obstruction in Parkinson’s disease

Gastrointestinal dysfunction, including constipation and dysphagia, are common in PD. Although both dysphagia and constipation correlate with PD severity, and Lewy bodies have been identified in both the esophageal and colonic wall, neither problem has been reported to respond well to dopaminergic therapy.1,2 We report a patient with PD and constipation who developed acute esophageal obstruction when using the laxative Perdiem (Ciba; Woodbridge, NJ).

A 69-year-old man with a 6-year history of levodopa-responsive PD presented to the emergency room because of the sudden onset of severe choking. Just before the emergency room visit he had taken Perdiem and had felt the granules lodge in his throat. In accordance with the medication directions he drank a glass of cold water to clear his throat. However, instead of clearing the granules, he immediately experienced a sensation of a progressively expanding mass in his throat. He experienced increasing pressure in …