“Swallowing Difficulties” May Serve as Early Warning Signs of Parkinson’s Disease
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“Swallowing Difficulties” May Serve as Early Warning Signs of Parkinson’s Disease
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“Swallowing Difficulties” May Serve as Early Warning Signs of Parkinson’s Disease.
Recent research published in the journal “Gut” suggests that gastrointestinal issues such as constipation, swallowing difficulties, and irritable bowel syndrome (IBS) might be early indicators of Parkinson’s disease.
Gastrointestinal symptoms have been recognized as potential precursors to neurological conditions like strokes or cerebral aneurysms, as well as Alzheimer’s disease, following the “Braak hypothesis” that suggests intestinal disorders could also precede Parkinson’s disease.
A new study indicates that certain gastrointestinal conditions, including constipation, swallowing difficulties, and non-diarrheal irritable bowel syndrome, could be harbingers of Parkinson’s disease. The research analyzed data from the U.S. healthcare records network and found that these digestive problems were more common among patients diagnosed with Parkinson’s disease before the onset of the disease.
To validate this hypothesis, researchers used data from the U.S. National Healthcare Records Network (TriNetX) to compare 24,624 patients diagnosed with idiopathic Parkinson’s disease to those diagnosed with other neurological conditions—Alzheimer’s disease (19,046 individuals) or cerebrovascular diseases (23,942 individuals)—or those without the aforementioned conditions (24,624 individuals, the control group).
Patients with Parkinson’s disease were matched with patients from the other groups in terms of age, gender, race, ethnicity, and time of diagnosis, allowing for a comparison of the frequency of gastrointestinal disorders in their electronic health records over an average of 6 years before the diagnosis of Parkinson’s disease.
Subsequently, researchers tested the same hypothesis in various ways, categorizing all adults with any of the 18 gastrointestinal diseases in the network into separate groups, each representing a specific ailment. These groups were paired with individuals without any specific gastrointestinal disease and monitored for 5 years through their medical records to see how many developed Parkinson’s disease or other neurological conditions. Both analyses indicated an increased risk of Parkinson’s disease with four gastrointestinal conditions.
Specifically, delayed gastric emptying, swallowing difficulties, and constipation were associated with over a doubling of the risk of developing Parkinson’s disease within 5 years before the definitive diagnosis, while non-diarrheal irritable bowel syndrome was associated with a 17% increased risk.
Researchers noted that the removal of the appendix appeared to have a protective effect, raising questions about the potential role of the appendix in the disease process leading to Parkinson’s. Inflammatory bowel disease and vagotomy surgery (the removal of all or part of the vagus nerve to treat peptic ulcers) were not associated with an elevated risk.
Some other gastrointestinal issues, including functional dyspepsia (unexplained stomach burning or fullness), irritable bowel syndrome with diarrhea, and diarrhea with fecal incontinence, were also more common among Parkinson’s disease patients. However, these conditions were also more prevalent before the onset of Alzheimer’s disease or cerebrovascular diseases.
This was an observational study, and therefore, causation cannot be determined. Researchers also highlighted certain limitations of their study, including the relatively short monitoring period and potential incompleteness of diagnostic information in electronic health records.
Nevertheless, they concluded, “This study provides, for the first time, substantial observational evidence that clinical diagnoses of not only constipation but also swallowing difficulties, gastroparesis, and non-diarrheal irritable bowel syndrome may be particularly predictive of subsequent Parkinson’s disease development.”
They added, “These findings warrant vigilance for [gastrointestinal] syndromes in high-risk individuals for Parkinson’s disease and emphasize the need for further investigation of [gastrointestinal] antecedents of Alzheimer’s disease and cerebrovascular diseases.”
“Swallowing Difficulties” May Serve as Early Warning Signs of Parkinson’s Disease
(source:internet, reference only)
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