Journal Article

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

Desa, Siti Hajar Md, Tajurruddin, Farah Waheeda, Ahmad, Norfazilah, Ali, Raja Affendi Raja, Ibrahim, Norlinah Mohamed, Manaf, Mohd Rizal Abdul, Qin, Wong Zhi, Ibrahim, Azliza

2020

Overview

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. 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). 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. 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.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Biology and Life Sciences / Care and treatment / Clinical trials / Constipation / Constipation - drug therapy / Constipation - etiology / Constipation - physiopathology / Double-Blind Method / Female / Fermented milk products / Gastric motility / Gastroenterology / Gastrointestinal Microbiome - drug effects / Gastrointestinal Motility - drug effects / Gastrointestinal Motility - physiology / Health aspects / Hospitals / Humans / Intestine / Lactose / Male / Medicine / Medicine and Health Sciences / Microorganisms / Middle Aged / Milk / Motility / Movement disorders / Neurodegenerative diseases / Neurology / Parkinson Disease - complications / Parkinson Disease - physiopathology / Parkinson's disease / Pathogenesis / Pharmacists / Placebos / Probiotics / Probiotics - administration & dosage / Probiotics - therapeutic use / Quality of life / Questionnaires / Side effects / Signs and symptoms / Surveys and Questionnaires / Transit time / Treatment Outcome