A retrospective cohort study using Mass General Brigham records examined approximately 20,000 patients who underwent upper endoscopy with biopsy (2000–2005) and analyzed 11,293 without prior Parkinson’s disease (PD). Patients with endoscopic evidence of upper gastrointestinal (GI) mucosal damage (erosions, esophagitis, ulcers, peptic injury) had a higher subsequent PD diagnosis rate than those without damage (2.2% vs 0.5%; incidence rate ratio 4.15). This association persisted after adjustment for age, sex, race, comorbidity, constipation, dysphagia, and H. pylori (HR 1.76). Older age, higher Charlson-Deyo index, constipation (HR 2.65), and dysphagia (HR 2.33) also predicted PD. In nested case-control analyses, among patients with mucosal damage, H. pylori ([adjusted odds ratio aOR] 3.84) and GERD (aOR 3.92) were associated with increased PD odds.
Findings support a potential gut–brain link in PD pathogenesis and suggest that mucosal damage and related conditions may flag elevated clinical PD susceptibility. However, results are associative and limited by single-system data, reliance on ICD codes, baseline differences, small nested samples, and possible unmeasured confounding. The authors propose heightened monitoring of patients with documented mucosal damage, timely detection/treatment of H. pylori, and development of gut biomarkers. They also call for prospective, multi-center studies to test causality and evaluate whether managing GI pathology can modify PD risk.
Reference: Brooks A. Upper GI Mucosal Damage Linked to Increased Risk of Parkinson Disease. HCP Live. Published September 9, 2024. Accessed October 24, 2025. https://www.hcplive.com/view/upper-gi-mucosal-damage-linked-increased-risk-parkinson-disease
Link: https://www.hcplive.com/view/upper-gi-mucosal-damage-linked-increased-risk-parkinson-disease
