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Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study

To determine whether probiotics are effective for constipation, a common and often difficultto-treat problem, in Parkinson disease (PD). Methods In this double-blind, randomized, placebo-controlled, single-center trial, 280 patients with PD were screened, and 72 eligible patients were block-randomiz...

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Main Authors:	Tan, Ai Huey, Lim, Shen-Yang, Chong, Kah Kian, Manap, Mohammad Addin Azhan A., Hor, Jia Wei, Lim, Jia Lun, Low, Soon Chai, Chong, Chun Wie, Mahadeva, Sanjiv, Lang, Anthony E.
Format:	Article
Published:	American Academy of Neurology 2021
Subjects:	QR Microbiology R Medicine RA Public aspects of medicine RC Internal medicine
Online Access:	http://eprints.um.edu.my/34389/
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spelling	my.um.eprints.343892022-09-13T05:42:52Z http://eprints.um.edu.my/34389/ Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study Tan, Ai Huey Lim, Shen-Yang Chong, Kah Kian Manap, Mohammad Addin Azhan A. Hor, Jia Wei Lim, Jia Lun Low, Soon Chai Chong, Chun Wie Mahadeva, Sanjiv Lang, Anthony E. QR Microbiology R Medicine RA Public aspects of medicine RC Internal medicine To determine whether probiotics are effective for constipation, a common and often difficultto-treat problem, in Parkinson disease (PD). Methods In this double-blind, randomized, placebo-controlled, single-center trial, 280 patients with PD were screened, and 72 eligible patients were block-randomized (1:1) to receive either multistrain probiotics capsules (n = 34) or identical-appearing placebo (n = 38), for 4 weeks. The primary endpoint was the change in the average number of spontaneous bowel movements (SBM) per week during the last 2 weeks of intervention compared with the 2-week preintervention phase, recorded by daily stool diary. Secondary outcome measures included changes in stool consistency, constipation severity score, and quality of life related to constipation. Satisfaction with intervention received was assessed. Change in levels of fecal calprotectin, a marker of intestinal inflammation, was an exploratory outcome. Results SBM increased by 1.0 +/- 1.2 per week after treatment with probiotics and decreased by 0.3 +/- 1.0 per week in the placebo group (mean difference 1.3, 95% confidence interval 0.8-1.8, p < 0.001). Significant improvements were also seen for secondary outcomes after correction for multiple comparisons, including stool consistency (p = 0.009) and quality of life related to constipation (p = 0.001). In the treatment group, 65.6% reported satisfaction with the intervention vs only 21.6% in the placebo group (p < 0.001). One patient (2.9%) in the treatment group withdrew due to a nonserious adverse event. Fecal calprotectin did not change significantly during the study. Conclusions Multistrain probiotics treatment was effective for constipation in PD. Further studies are needed to investigate the long-term efficacy and safety of probiotics in PD, as well as their mechanisms of action. Classification of Evidence This study provides Class I evidence that, for people with PD, multistrain probiotics significantly increased the average number of SBM per week. American Academy of Neurology 2021-02 Article PeerReviewed Tan, Ai Huey and Lim, Shen-Yang and Chong, Kah Kian and Manap, Mohammad Addin Azhan A. and Hor, Jia Wei and Lim, Jia Lun and Low, Soon Chai and Chong, Chun Wie and Mahadeva, Sanjiv and Lang, Anthony E. (2021) Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study. Neurology, 96 (5). E772-E782. ISSN 0028-3878, DOI https://doi.org/10.1212/WNL.0000000000010998 <https://doi.org/10.1212/WNL.0000000000010998>. 10.1212/WNL.0000000000010998
institution	Universiti Malaya
building	UM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Malaya
content_source	UM Research Repository
url_provider	http://eprints.um.edu.my/
topic	QR Microbiology R Medicine RA Public aspects of medicine RC Internal medicine
spellingShingle	QR Microbiology R Medicine RA Public aspects of medicine RC Internal medicine Tan, Ai Huey Lim, Shen-Yang Chong, Kah Kian Manap, Mohammad Addin Azhan A. Hor, Jia Wei Lim, Jia Lun Low, Soon Chai Chong, Chun Wie Mahadeva, Sanjiv Lang, Anthony E. Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
description	To determine whether probiotics are effective for constipation, a common and often difficultto-treat problem, in Parkinson disease (PD). Methods In this double-blind, randomized, placebo-controlled, single-center trial, 280 patients with PD were screened, and 72 eligible patients were block-randomized (1:1) to receive either multistrain probiotics capsules (n = 34) or identical-appearing placebo (n = 38), for 4 weeks. The primary endpoint was the change in the average number of spontaneous bowel movements (SBM) per week during the last 2 weeks of intervention compared with the 2-week preintervention phase, recorded by daily stool diary. Secondary outcome measures included changes in stool consistency, constipation severity score, and quality of life related to constipation. Satisfaction with intervention received was assessed. Change in levels of fecal calprotectin, a marker of intestinal inflammation, was an exploratory outcome. Results SBM increased by 1.0 +/- 1.2 per week after treatment with probiotics and decreased by 0.3 +/- 1.0 per week in the placebo group (mean difference 1.3, 95% confidence interval 0.8-1.8, p < 0.001). Significant improvements were also seen for secondary outcomes after correction for multiple comparisons, including stool consistency (p = 0.009) and quality of life related to constipation (p = 0.001). In the treatment group, 65.6% reported satisfaction with the intervention vs only 21.6% in the placebo group (p < 0.001). One patient (2.9%) in the treatment group withdrew due to a nonserious adverse event. Fecal calprotectin did not change significantly during the study. Conclusions Multistrain probiotics treatment was effective for constipation in PD. Further studies are needed to investigate the long-term efficacy and safety of probiotics in PD, as well as their mechanisms of action. Classification of Evidence This study provides Class I evidence that, for people with PD, multistrain probiotics significantly increased the average number of SBM per week.
format	Article
author	Tan, Ai Huey Lim, Shen-Yang Chong, Kah Kian Manap, Mohammad Addin Azhan A. Hor, Jia Wei Lim, Jia Lun Low, Soon Chai Chong, Chun Wie Mahadeva, Sanjiv Lang, Anthony E.
author_facet	Tan, Ai Huey Lim, Shen-Yang Chong, Kah Kian Manap, Mohammad Addin Azhan A. Hor, Jia Wei Lim, Jia Lun Low, Soon Chai Chong, Chun Wie Mahadeva, Sanjiv Lang, Anthony E.
author_sort	Tan, Ai Huey
title	Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
title_short	Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
title_full	Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
title_fullStr	Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
title_full_unstemmed	Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study
title_sort	probiotics for constipation in parkinson disease :a randomized placebo-controlled study
publisher	American Academy of Neurology
publishDate	2021
url	http://eprints.um.edu.my/34389/
_version_	1744649177063751680
score	13.211869

Probiotics for constipation in Parkinson disease :A randomized placebo-controlled study

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