Gastrointestinal Damage Caused By Heartburn Drugs, NSAIDs May Lead to Parkinson’s Disease: Study

Patients with gastrointestinal conditions, especially those that damage the mucosal lining of the esophagus and stomach, appear to face a higher risk of developing Parkinson’s disease later in life, according to the findings of a new study.

In a new report published in this month’s issue of the medical journal JAMA Network Open, researchers found that patients with damage to the lining of the small intestine, esophagus and other gastrointestinal areas were at 76% higher risk of developing Parkinson’s, especially if they used heartburn drugs like Prilosec and Nexium, or popular pain relievers, such as Advil, Motrin or Aleve.

Parkinson’s disease is a progressive condition that affects the central nervous system, causing symptoms like tremors and bodily stiffness. While medications can help control the symptoms, there is no cure for the devastating disorder.

In the past, researchers have widely believed in a “top-down” Parkinson’s disease hypothesis, meaning it starts in the brain and slowly affects other parts of the body. However, a “gut-first” hypothesis of Parkinson’s has gained traction recently in the medical community, suggesting the disease begins in the gut and progresses from there.

Researchers say this latest study adds to a growing body of evidence that affirms the “gut-first” Parkinson’s disease hypothesis, suggesting that individuals taking a number of different drugs that may damage the esophagus or stomach may be more likely to develop the condition.

In this new study, Dr. Subhash Kulkarni and Jocelyn J. Chang led researchers from Tufts University School of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School to focus their study on damage to the mucus of the upper gastrointestinal tract.

They conducted an upper endoscopy with biopsy on 9,350 patients with no history of Parkinson’s disease from 2000 to 2005. Patients with mucosal damage were matched to patients without mucosal damage, such as gastrointestinal erosion, esophagitis, ulcers or peptic injury.

Researchers found that patients with damage to the gastrointestinal tract were 76% more likely to develop Parkinson’s disease later in life.

The study also found that patients who were diagnosed with Parkinson’s disease were also more likely to have a history of H. pylori infection, acid reflux disease, smoking, constipation and difficulty swallowing. They were also more likely to have a history of using proton pump inhibitor (PPI) drugs, including heartburn medications like Prilosec and Nexium, as well as chronic nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil, Motrin and Aleve.

Heartburn Drug and NSAID Gastrointestinal Risks

Proton pump inhibitors like Prilosec, Nexium and Prevacid are designed to reduce the amount of acid in the stomach to help with ulcers, acid reflux and other gastrointestinal conditions.

However, research indicates using these kinds of heartburn drugs may lead to an increased risk of side effects, such as kidney disease and kidney failure, as well as increasing the risk of death by up to 25%.

Data also indicates many doctors give older adults unnecessary PPI prescriptions, which offer no medical benefit and may increase their risk of experiencing serious side effects.

Prior studies have linked the use of NSAIDs to an increased risk of intestinal bleeding. Additionally, research focused on reducing the risk of Parkinson’s disease with the use of high doses of NSAIDs such as Advil or aspirin has failed, with a recent study finding that NSAIDs do not decrease the risk of getting Parkinson’s disease, so there is little benefit to prescribing the drugs to patients who don’t need them.

As a result of these new findings, researchers indicate that doctors should monitor patients with upper gastrointestinal mucosal damage for future Parkinson’s disease risk, especially if they have other conditions like ulcers and esophagitis.

“In this cohort study, a history of upper gastrointestinal MD (mucosal damage) was associated with elevated risk of developing a clinical PD diagnosis,” the research team concluded. “Increased vigilance among patients with MD for future PD risk may be warranted.”