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New research suggests that various digestive problems such as constipation, difficulty swallowing, and irritable bowel syndrome (IBS) could potentially serve as early indicators of Parkinson’s disease. These findings have been documented in the journal “Gut.”
The hypothesis known as Braak’s hypothesis has suggested that gastrointestinal disorders might precede the onset of Parkinson’s disease. According to this theory, gastrointestinal symptoms could manifest before the development of other cerebrovascular conditions such as stroke or brain aneurysm, as well as before the onset of Alzheimer’s disease.
To investigate this hypothesis, researchers conducted a study using data from a nationwide US medical record network called TriNetX. The study involved a comparison of 24,624 individuals diagnosed with unexplained Parkinson’s disease, along with groups diagnosed with other neurological conditions such as Alzheimer’s disease (19,046 cases) or cerebrovascular disease (23,942 cases), and a comparison group with none of these conditions (24,624 individuals). The aim was to explore potential associations between gut disorders and the development of Parkinson’s disease.
The study ensured that individuals with Parkinson’s disease were matched with counterparts from the other groups based on factors like age, sex, race and ethnicity, as well as the duration of their diagnosis. This allowed the researchers to compare the occurrence of gut conditions in their electronic health records over an average of 6 years before the diagnosis of Parkinson’s disease.
Furthermore, the researchers employed a different approach to test the same hypothesis. They grouped adults in the medical network who had been diagnosed with any of 18 gut conditions into separate categories, each focused on a specific condition of interest. Individuals in these groups were paired with individuals lacking the particular gut condition, and their medical records were tracked for 5 years to observe the incidence of Parkinson’s disease or other neurological disorders.
Both types of analyses unveiled a connection between certain gut conditions and a heightened risk of Parkinson’s disease diagnosis. Precisely, delayed stomach emptying (gastroparesis), difficulty swallowing (dysphagia), and constipation were all associated with more than a twofold increase in the risk of developing Parkinson’s disease in the 5 years leading up to the diagnosis. Additionally, irritable bowel syndrome (IBS) without diarrhea was linked to a 17 percent higher risk.
Interestingly, the removal of the appendix was linked to a protective effect, prompting researchers to raise questions about its potential role in the processes leading to Parkinson’s disease.
However, neither inflammatory bowel disease nor vagotomy (the surgical removal of part or all of the vagus nerve, often done to treat peptic ulcers) displayed an increased risk of Parkinson’s disease.
Some other gut-related issues, such as functional dyspepsia (a sensation of burning or fullness in the stomach without an apparent cause), IBS with diarrhea, and the combination of diarrhea and fecal incontinence, were also more commonly seen among individuals who later developed Parkinson’s disease. Yet, these conditions were also more prevalent before the onset of Alzheimer’s disease or cerebrovascular disease.
The study is purely observational and cannot establish causal relationships. The researchers also acknowledge several limitations to their findings. These include the relatively short monitoring period and the possibility that diagnostic information within electronic health records might not have been entirely comprehensive.
In spite of the study’s limitations, the researchers draw significant conclusions, stating, “This study is the first to provide substantial observational evidence that the clinical diagnosis of not only constipation but also dysphagia, gastroparesis, and irritable bowel syndrome without diarrhea may specifically predict the eventual development of Parkinson’s disease.”
The researchers further emphasize that these findings underscore the importance of remaining vigilant for gastrointestinal syndromes in individuals at an elevated risk for Parkinson’s disease. They also stress the necessity for further exploration of gastrointestinal conditions that might precede the onset of Alzheimer’s disease and cerebrovascular disease.
