Parkinson's gut symptoms may appear decades before tremors, doctor says
Dr. Trisha Pasricha told CBS News’ “Healthful” that constipation and REM sleep disorder may point to Parkinson’s risk years early.
By Frankie Delgado · News Reporter
3 min read
Parkinson's gut symptoms may show up years, or even decades, before the tremors most people associate with the disease, Dr. Trisha Pasricha said on CBS News' “Healthful.”
Pasricha, a double board-certified internal medicine physician and gastroenterologist, is the head of the Gut-Brain Institute and an assistant professor at Harvard Medical School. She told host Norah O'Donnell that patients and doctors may need to think of the gut as more than a digestive tube.
“I think the reframe that really helps is if you stop thinking about your gut as plumbing, you think about it as a brain,” Pasricha said on the program.
Can gut symptoms be early signs of Parkinson's?
Pasricha said researchers have made major headway in identifying symptoms that can precede Parkinson's motor problems. She pointed to the “first-gut theory” of Parkinson's, the idea that some cases may begin in the gut rather than the brain.
According to Pasricha, a key feature of Parkinson's is a misfolded protein that damages dopamine-producing neurons in the brain. That damage is linked to the tremors commonly associated with the disease.
Studies have indicated that the protein may begin misfolding in the gut before moving to the brain, Pasricha said. She added that many of her Parkinson's patients deal with severe gastrointestinal problems, including constipation and nausea, that began long before their tremors appeared.
Pasricha said she hopes doctors may be able to diagnose prodromal Parkinson's through the gut within 10 to 15 years. Prodromal Parkinson's refers to an early phase of the disease before the classic movement symptoms are present.
She also named REM sleep disorder as another possible early clue. In that condition, dreams can become vivid enough that a person starts to move during sleep, she said.
What did Pasricha say about GLP-1s and the gut?
Pasricha also addressed GLP-1s, which are widely discussed for side effects such as constipation, nausea and indigestion. Despite those complaints, she said her lab found that people using GLP-1s were less likely to develop ulcers and colorectal cancer, along with a dozen other cancers.
She said researchers think the reduced cancer risk may be tied to lower inflammation in the gut and the rest of the body. The comments framed GLP-1s as a more complicated gut story than side effects alone.
How much fiber should adults get?
Pasricha said 95% of Americans are not hitting their fiber targets, even though fiber supports heart health and brain health and helps reduce inflammation.
Her guidance: add fiber rather than focusing first on removing foods from the plate. She said women under 50 should aim for 25 grams of fiber a day, while women over 50 should get 21 grams. Men under 50 should aim for 38 grams, and men over 50 should get 30 grams.
Pasricha said she feeds her children berries, nuts and Greek yogurt popsicles for breakfast. She also suggested packing a fiber supplement while traveling to help keep intake up.
The conversation aired on “Healthful” and is available through CBS News' video and podcast platforms.
This story draws on original reporting from CBS News.