Multi-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial

Abstract

Objective We determined the effectiveness of a multi-strain probiotic (Hexbio®) containing microbial cell preparation MCP®BCMC® on constipation symptoms and gut motility in PD patients with constipation. Methods PD patients with constipation (ROME III criteria) were randomized to receive a multi-strain probiotic (Lactobacillus sp and Bifidobacterium sp at 30 X 109 CFU) with fructo-oligosaccaride or placebo (fermented milk) twice daily for 8 weeks. Primary outcomes were changes in the presence of constipation symptoms using 9 items of Garrigues Questionnaire (GQ), which included an item on bowel opening frequency. Secondary outcomes were gut transit time (GTT), quality of life (PDQ39-SI), motor (MDS-UPDRS) and non-motor symptoms (NMSS). Results Of 55 recruited, 48 patients completed the study: 22 received probiotic and 26 received placebo. At 8 weeks, there was a significantly higher mean weekly BOF in the probiotic group compared to placebo [SD 4.18 (1.44) vs SD 2.81(1.06); (mean difference 1.37, 95% CI 0.68, 2.07, uncorrected p<0.001)]. Patients in the probiotic group reported five times higher odds (odds ratio = 5.48, 95% CI 1.57, 19.12, uncorrected p = 0.008) for having higher BOF (< 3 to 3–5 to >5 times/week) compared to the placebo group. The GTT in the probiotic group [77.32 (SD55.35) hours] reduced significantly compared to placebo [113.54 (SD 61.54) hours]; mean difference -36.22, 95% CI -68.90, -3.54, uncorrected p = 0.030). The mean change in GTT was 58.04 (SD59.04) hour vs 20.73 (SD60.48) hours respectively (mean difference 37.32, 95% CI 4.00, 70.63, uncorrected p = 0.028). No between-groups differences were observed in the NMSS, PDQ39-SI, MDS-UPDRS II and MDS-UPDRS III scores. Four patients in the probiotics group experienced mild reversible side effects. Conclusion This study showed that consumption of a multi-strain probiotic (Hexbio®) over 8 weeks improved bowel opening frequency and whole gut transit time in PD patients with constipation.

Therapeutic Targets of Probiotics in Parkinson Disease: A Systematic Review of Randomized Controlled Trials

“…Elaheh Amirani et al95% CI: -0.06 to 1.18) (Krüger, Hillesheim & Pereira, 2020). The MDA-UPDRS and NMSS were improved after usage of probiotics(Ibrahim et al, 2020). In chronic phase of PD, it is possible that cognition and brain functions are associated.…”

“…Ibrahim et al reported increased bowel opening frequency (BOF) and gut transit time (GTT)decreased in Parkinson's patients after 8 weeks usage of Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus lactis, Bifidobacterium infantis, Bifidobacterium longum(Ibrahim et al, 2020).In addition, following 4 weeks of using fermented milk containing several probiotic strains and prebiotic fiber, Barichella et al showed an increase in complete bowel movement (CBM)(Barichella et al, 2016). After 4 weeks of using a probiotic pill containing 10 billion CFU of eight different commercially available bacterial strains (Lactobacillus reuteri, Lactobacillus acidophilus, Lactobacillus gasseri, Bifidobacterium bifidum, Lactobacillus rhamnosus, Bifidobacterium longum, Enterococcus faecium, Enterococcus faecalis), spontaneous bowel movements (SBM) increased.…”

Probiotic Supplements: Their Strategies in the Therapeutic and Prophylactic of Human Life-Threatening Diseases

“…and Bifidobacterium spp. have improved gut movement and ameliorated constipation in Parkinson’s disease patients [ 69 ]. Additionally, meta-analysis research on 2327 topics related to the influence of probiotics on chronic constipation in individuals revealed that oral intake of probiotics, particularly multi-strain probiotics, can primarily shorten gut transit time and increase fecal regularity [ 70 ].…”

Clinical and Pre-Clinical Evidence for Enteric α-Synuclein Involvement in Parkinson's Disease

“…This also supposes that the constipation often present in PD is caused by GI dysbiosis. To compliment this proposition, treatment with probiotics to repopulate the GI flora has successfully been implemented to alleviate PD-associated constipation [96][97][98]. Fecal microbiota transplantation (FMT) has likewise been used to treat constipation, with the first case report finding increased gastric motility and decreased leg tremors following FMT transplant through transendoscopic enteral tubing [99].…”