Can probiotics improve constipation among patients with Parkinson’s disease? Original paper

Constipation is common among patients with Parkinson's disease (PD). Because the gut microbiota may play a role in PD-related gastrointestinal dysfunction, could probiotic supplementation offer constipation relief for patients?

This 4-week double-blind randomized controlled trial assessed the efficacy of multistrain probiotics as a treatment for constipation. A total of 72 PD patients who fulfilled the Rome IV criteria for functional constipation (<3 spontaneous bowel movements (SBM) per week for the past 3 months, with symptom onset ≥6 months ago) were randomized to receive either a multistrain probiotic or a placebo once per day. Each probiotic capsule contained 10 billion colony forming units (CFU) of 8 different bacterial strains (Lactobacillus acidophilus, Lactobacillus reuteri, Lactobacillus gasseri, Lactobacillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium longum, Enterococcus faecalis and Enterococcus faecium).

The primary outcome was the average number of SBMs per week during the last 2 weeks of the intervention, compared to the 2 weeks before the intervention, as assessed via a daily stool diary. The secondary outcomes were changes in stool consistency, constipation severity score, and constipation quality-of-life (PAC-QOL) score. The authors also assessed participant satisfaction with the intervention and change in fecal calprotectin (a marker of intestinal inflammation).

SBM increased significantly more in the probiotic group than the placebo group. Stools became softer and PAC-QOL increased in the probiotic group compared to the placebo group. The probiotic group experienced a nonsignificant improvement in constipation severity score and a nonsignificant reduction in laxative use compared to the placebo group. Of the participants allocated to probiotics, 65.6% reported satisfaction with the intervention, compared to only 21.6% in the placebo group. Fecal calprotectin did not differ between groups.