Researchers have linked upper gastrointestinal tract damage to a higher risk for developing Parkinson’s disease.
The report, published Sept. 5 in JAMA Network Open, showed that mucosal damage seen on an upper endoscopy was linked to having a 76% higher risk for the disease.
When the study started, those with mucosal damage (MD) were more likely to have a history of helicobacter pylori infection, proton-pump inhibitors use, chronic nonsteroidal anti-inflammatory drug use, gastroesophageal reflux disease, smoking, constipation, or difficulty swallowing, the researchers noted.
Investigators evaluated 9,350 people who had an upper endoscopy with biopsy between January 2000 and December 2005 in the Mass General Brigham system. They matched study participants with MD to those without in a 1-to-3 ratio. Then the team followed up in July 2023 to compare results.
Over the follow-up period, 52 patients (2.2%) of the 2,338 with MD were diagnosed with Parkinson’s disease. Only 0.5% of the 8955 patients without MD developed Parkinson’s. The average time between detection of MD and diagnosis of Parkinson’s disease was just over 14 years; the average age when the people were diagnosed with Parkinson’s was 73.
“Here, we showed for the first time that a history of upper gastrointestinal mucosal damage, which we confirmed by looking at endoscopic and pathology reports, was associated with a 76% greater risk of developing Parkinson’s disease,” Trisha Pasricha, MD, an author from Beth Israel Deaconess Medical Center in Boston, said in an article on MedPage Today.
Pasricha cited some evidence showing that Parkinson’s disease may start in the gut.
“We know that many patients with Parkinson’s disease experience symptoms like constipation or trouble swallowing years, or even decades, before they get motor symptoms. And studies have found alpha-synuclein deposition throughout the gastrointestinal tract,” she said.
“Dopamine plays an important role in gastrointestinal mucosal integrity,” she said. “So, is mucosal damage the trigger that leads to pathologic alpha-synuclein misfolding, or do people destined to develop Parkinson’s have subclinical decreases in dopamine increasing their risk of mucosal damage well in advance of motor symptoms? Those are the kinds of questions we’re working on next.”
