Dr. Trisha Pasricha

And that's sort of how we thought about Parkinson's for several decades.

And we know that certain risk factors for Parkinson's, like, for example, in America, where people play football and they get head injuries and concussions, that can certainly put you at increased risk of Parkinson's.

And what we know also to be true is that there is this protein called alpha-synuclein that misfolds.

And when it misfolds, it seems to be involved in why these particular dopamine neurons die.

And they die in a part of the brain responsible for movement.

And so that's why we think they get the tremors and rigidity.

But later on in the 90s and 2000s, they started to do these studies where they looked at autopsies of people who had Parkinson's disease, but they looked at their guts instead of looking at their brains.

And it turns out their guts were riddled with this misfolded alpha-synuclein protein.

80% of people with Parkinson's disease have some GI issue, constipation, nausea, trouble swallowing.

It's so severe, and it turns out having constipation early in life is a predictor of Parkinson's disease later.

Yeah.

And again, constipation, just to be so clear, incredibly common.

in our society.

So everyone who has constipation is not going to get Parkinson's disease, but it is associated with a pretty significant increased risk.

And especially when people start to say, oh yeah, I have constipation and someone, this is someone in their forties, maybe 50, like a little bit earlier than you would think of necessarily off the bat for Parkinson's.

But if they say I have constipation, this is new.

Maybe they have a family history of Parkinson's or they say I've lost my sense of smell or I'm having trouble sleeping.

There are all these other signs that are not necessarily directly related to their brain per se and the tremors that you might say, wait, this is starting to form a more suspicious picture for Parkinson's.

Yeah, that's absolutely right.

We think that for a subset of patients, there's some trigger that occurs in the gut first.