Common gut issues ‘could be warning sign of Parkinson’s disease’

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Common gut problems such as constipation or irritable bowel syndrome (IBS) could be a warning sign of Parkinson’s disease, a study has suggested.

It is hoped the findings – published in the medical journal Gut – will make doctors take note when patients at risk of Parkinson’s report gut issues. A team of scientists from Belgium and the US explored Braak’s hypothesis, which states that Parkinson’s disease originates in the gastrointestinal tract.

Similar suggestions have been made for the likes of Alzheimer’s disease and ‘cerebrovascular disease’, also known as brain aneurysm and stroke. They used data from the US medical record network TriNetX comprising 24,624 people with Parkinson’s, 19,046 people with Alzheimer’s and 23,942 people with cerebrovascular disease.

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Those with Parkinson’s were matched with patients in other groups by age, sex, race and length of diagnosis, with the frequency of gut conditions compared on their records for an average of six years before diagnosis. The team then divided all the adults in the network who had been diagnosed with any one of 18 gut conditions into separate groups.

They were then matched with people without the gut condition and monitored via medical records for five years to see how many developed Parkinson’s or other neurological diseases. Both studies found four gut conditions were associated with a higher risk of Parkinson’s.

These included constipation, difficulty swallowing and gastroparesis – a condition that slows the movement of food to the small intestine – which were all associated with a doubling in risk for developing Parkinson’s in the five years prior to diagnosis. Patients suffering from IBS without diarrhoea were 17% more at risk.

The team said the study “is the first to establish substantial observational evidence” that a clinical diagnosis of gut issues “might specifically predict the development of Parkinson’s disease”. They added: “These findings warrant alertness for (gastrointestinal) syndromes in patients at higher risk for Parkinson’s disease and highlight the need for further investigation of (gastrointestinal) precedents in Alzheimer’s disease and cerebrovascular disease.”

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Clare Bale, associate director of research at Parkinson’s UK, said the “findings add further weight” to the hypothesis and gut problems could be an early sign of the disease. She added: “Understanding how and why gut issues appear in the early stages of Parkinson’s could open up opportunities for early detection and treatment approaches that target the gut to improve symptoms and even slow or stop the progression of the condition.”

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