Introduction

Certain bowel problems, such as constipation, difficulty swallowing, and irritable bowel syndrome (IBS), may be early signs of approaching Parkinson’s disease, suggests a study published in the journal Gut.

Background

Gastrointestinal symptoms are thought to precede the development of cerebrovascular diseases such as stroke, cerebral aneurysm, or Alzheimer’s disease. A new study now suggests that bowel disease may also precede the development of Parkinson’s disease.

Study Details

To test this hypothesis, the researchers used data from the U.S. National Health Records Network (TriNetX). They compared 24,624 people diagnosed with Parkinson’s disease of unknown cause with people diagnosed with other neurological conditions, such as Alzheimer’s disease or cerebrovascular disease.

People with Parkinson’s disease were compared with people from other groups by age, gender, race, ethnicity, and duration of diagnosis. The researchers analyzed the incidence of bowel diseases included in their electronic health records, on average 6 years before they were diagnosed with Parkinson’s disease.

The researchers also divided all the adults in the network who had been diagnosed with any of the 18 intestinal diseases into separate groups. They compared these groups with people without a specific bowel disease who were followed up with medical records for 5 years. The goal was to see how many people developed Parkinson’s disease or other neurological disorders.

Key Findings

Both analyses showed that four gastrointestinal conditions were associated with an increased risk of being diagnosed with Parkinson’s disease. Gastroparesis, dysphagia, and constipation were associated with a more than two-fold increase in the risk of developing Parkinson’s disease in the five years prior to diagnosis. IBS without diarrhea was associated with a 17% increase in risk of developing Parkinson’s disease.

However, the removal of the appendix appears to have a protective function, raising questions about its potential role in the pathological processes that lead to Parkinson’s disease, according to the researchers.

Neither inflammatory bowel disease nor vagotomy (removal of all or part of the vagus nerve to treat peptic ulcers) have been associated with an increased risk.

Several other bowel problems, including functional dyspepsia, irritable bowel syndrome, diarrhea, and fecal incontinence, were also more common among people with Parkinson’s disease. However, these conditions were also more common before the advent of Alzheimer’s or cerebrovascular disease.

Conclusion

This study is the first to demonstrate substantial observational evidence that a clinical diagnosis of not only constipation, but also dysphagia, gastroparesis, and irritable bowel syndrome without diarrhea can specifically predict the development of Parkinson’s disease. The results call for vigilance for gastrointestinal syndromes in patients at high risk of developing Parkinson’s disease and highlight the need for further study of gastrointestinal precursors of Alzheimer’s disease and cerebrovascular disease.

Source: Medical Express