Objective: To assess risk of Parkinson’s disease in patients with irritable bowel syndrome in the Finnish population.

Background: The majority of Parkinson’s disease (PD) patients suffer from gastrointestinal symptoms of which constipation is considered the most prominent. Recently, in addition to constipation, irritable bowel syndrome (IBS) was also found to be associated with increased PD risk in Taiwan (1). IBS is a disorder of gut-brain interaction characterised by abdominal pain and alteration of bowel habits. We wanted to test the hypothesis that a diagnosis of IBS is a risk factor for PD in the Finnish population.

Methods: We conducted a retrospective cohort study with 9563 IBS patients and 33563 controls using the data from the Finnish Care Register for Health Care (HILMO).  The study population was defined as all patients (aged 20 years or older) discharged from inpatient care, day surgeries or specialised outpatient care at least two times with diagnosis of IBS during 1998-2014. For each IBS patient, 4 reference patients of same age (±1 year), sex and born in the same municipality were sought. The controls were matched by index date of diagnosing IBS.  All subjects with a diagnosis with inflammable bowel disease, celiac disease, colorectal neoplasms or other movement disorders before or during the follow-up period were excluded from the study. Also patients diagnosed with PD before the index date were excluded. The hazard ratio for PD was assessed by a Cox proportional hazards model.

Results: After exclusions, the ratio of controls to IBS patients was 3.56:1. The demographic data of subjects is presented in Table 1. The PD incidence ratio per 10 000 person years was 4.12 for IBS patients and 2.12 for controls. The unadjusted hazard ratio (HR) for PD was 1.941 (95% CI: 1.225-3.007) for IBS patients compared to controls (p = 0.005). When adjusted for potential confounders age, gender, hypertension, diabetes, depression, peptic ulcer and history of transient ischemic attack or stroke, the HR was 1.942 (95% CI 1.233-3.058) for IBS patients (p = 0.004). [Table 1]

Conclusions: IBS appears to be an independent risk factor for PD in the Finnish population. Constipation is a known premotor symptom of PD (2). Our results indicate that patients may also have other gastrointestinal premotor symptoms prior the diagnosis of PD.

References: 1.         Lai SW, Liao KF, Lin CL, Sung FC. Irritable bowel syndrome correlates with increased risk of Parkinson’s disease in Taiwan. Eur J Epidemiol. 2014;29(1):57-62.

2.         Savica R, Carlin JM, Grossardt BR, Bower JH, Ahlskog JE, Maraganore DM, et al. Medical records documentation of constipation preceding Parkinson disease: A case-control study. Neurology. 2009;73(21):1752-8.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnosis-of-irritable-bowel-syndrome-increases-risk-of-parkinsons-disease-in-the-finnish-population/