‘No need for alarm,’ despite associations between certain GI conditions and Parkinson’s
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Key takeaways:
- Functional dyspepsia, irritable bowel syndrome with diarrhea, diarrhea and fecal incontinence were not specific to Parkinson’s disease.
- Cohort analysis showed appendectomy decreased the risk for Parkinson’s.
Case-control and cohort analyses showed dysphasia, gastroparesis, irritable bowel syndrome without diarrhea and constipation may be associated with an increased risk for Parkinson’s disease, according to research in Gut.
“We have been doing experimental studies that have shown that the pathological molecule that is associated with [Parkinson’s disease] can indeed travel from the gut to the brain,” Pankaj Jay Pasricha, MD, chair of the department of medicine at Mayo Clinic in Arizona, told Healio. “We now decided to test this hypothesis in another way, taking advantage of a national database with millions of patients.”
Using data from TriNetX, Pasricha and colleagues conducted a combined case-control and cohort study comparing individuals with new-onset idiopathic Parkinson’s disease (PD; n = 24,624) with matched negative controls and patients with “contemporary diagnoses” of Alzheimer’s disease (AD) and cerebrovascular disease (CVD). Researchers also compared cohorts for development of PD, AD and CVD within 5 years.
In both case-control and cohort analyses, gastroparesis (OR = 4.64 and RR = 2.43, respectively), dysphasia (OR = 3.58 and RR = 2.27), IBS without diarrhea (OR = 3.53 and RR = 1.17) and constipation (OR = 3.32 and RR = 2.38) showed “specific associations with PD” vs. negative controls. Functional dyspepsia, IBS with diarrhea, diarrhea and fecal incontinence were not specific to PD, while IBS with constipation and intestinal pseudo-obstruction showed specificity in both case-control (OR = 4.11) and cohort analyses (RR = 1.84).
“Certain gastrointestinal conditions that we believe result from dysfunction of the nerves in the gut itself — the enteric nervous system — may be associated with an increased risk of PD in the future,” Pasricha said. “This is just an association and does not prove cause or effect.”
Results also demonstrated that appendectomy decreased the risk for PD in the cohort analysis (RR = 0.48), while inflammatory bowel disease or vagotomy were not associated with PD.
Although researchers identified several GI conditions that might predict PD, Pasricha emphasized there is “no need for alarm.”
He added, “The overall risk for developing PD is low, so even a two to four increase still translates to a very low absolute risk. The overwhelming majority of patients with these GI conditions will never develop PD.
“Also, some of these findings are not new: Most experts have known for a very long time that constipation is a potential risk factor for PD. This study adds to the list of GI conditions that could potentially be risk factors.”
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