Constipation and irritable bowel syndrome may be early warning signs of Parkinson’s disease, according to new research.
Constipation was associated with a more than doubling in the risk of developing the neurological condition in the five years preceding diagnosis, say scientists.
Gastrointestinal symptoms have long been thought to precede a stroke or a brain aneurysm.
It has also been suggested that gut conditions may also precede the development of neurological conditions, such as Parkinson’s disease.
To test the theory, American researchers used data from a U.S. nationwide medical record network to compare 24,624 people who had been diagnosed with Parkinson’s disease of unknown cause with those who had been diagnosed with Alzheimer’s disease or cerebrovascular disease – or with none of them
Those with Parkinson’s disease were matched with people in the other groups for age, sex, race and ethnicity, and length of diagnosis to compare the frequency of gut conditions included in their electronic health record for an average of six years before their Parkinson’s disease diagnosis.
The research team then tested the same hypothesis, but in a different way, by dividing all the adults in the network who had been diagnosed with any of 18 gut conditions into separate groups – one for each condition of interest.
People in those groups were matched with people without the particular gut condition and monitored via their medical records for five years to see how many of them developed Parkinson’s disease or other neurological disorders.
Study author Dr. Pankaj Pasricha, of Mayo Clinic Arizona, said both analyses indicated that four gut conditions were associated with a higher risk of a Parkinson’s disease diagnosis.
He said, specifically, gastroparesis – delayed stomach emptying, dysphagia – difficulty swallowing, and constipation were all associated with a more than doubling in risk of Parkinson’s disease in the five years preceding the diagnosis, while IBS without diarrhea was associated with a 17 percent higher risk.
But the research team said appendix removal seemed to be protective, prompting questions about its potential role in the disease processes leading to Parkinson’s disease.
Neither inflammatory bowel disease nor vagotomy – removal of all or part of the vagus nerve to treat peptic ulcer – were associated with an increased risk.
Dr. Pasricha said some other gut issues, including functional dyspepsia – a burning sensation or fullness of the stomach with no obvious cause; IBS with diarrhea; and diarrhea plus incontinence, were also more prevalent among people who developed Parkinson’s disease.
But he said those conditions were also more prevalent before the onset of Alzheimer’s disease or cerebrovascular disease.
Dr. Pasricha pointed out that it was an observational study, and as such, can’t establish cause.
But he said: “This study is the first to establish substantial observational evidence that the clinical diagnosis of not only constipation, but also dysphagia, gastroparesis and irritable bowel syndrome without diarrhea might specifically predict the development of Parkinson’s disease.”
He 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.”
Produced in association with SWNS Talker
Edited by Arnab Nandy