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A retrospective cohort study has shown that gastrointestinal (GI) mucosal damage detected during upper gastrointestinal endoscopy increases risk of a subsequent Parkinson’s disease diagnosis by 76%.
Over an average of 15 years of follow-up, people with upper GI mucosal damage were more likely to develop Parkinson’s disease than those without, said Trisha Pasricha, MD, MPH, of Beth Israel Deaconess Medical Center in Boston.
Mucosal damage is defined as the presence of erosions, esophagitis, ulcers or peptic injuries based on esophagogastroduodenoscopy (EGD) or pathology reports.
The researchers found that patients with mucosal damage were more likely to have a history of Helicobacter pylori infection, the use of proton pump inhibitors, long-term use of nonsteroidal anti-inflammatory drugs, gastroesophageal reflux disease, smoking, constipation, and dysphagia.
“Recently, there has been a growing body of literature supporting the idea that Parkinson’s disease may originate in the gut in some patients,” said Trisha Pasricha.
“We know that many Parkinson’s patients experienced symptoms such as constipation or difficulty swallowing many years or even decades before they developed motor symptoms. Interestingly, individual cases show a higher correlation between peptic ulcers and Parkinson’s disease. We found for the first time that a history of upper gastrointestinal mucosal lesions confirmed by endoscopic and histologic studies was associated with a 76% increased risk of Parkinson’s disease,” she noted.
We emphasize that this is a study of interrelationship rather than causation, which is what makes these results so intriguing.
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