Probiotics and prebiotic fiber for constipation associated with Parkinson disease: An RCT

Neurology. 2016 Sep 20;87(12):1274-80. doi: 10.1212/WNL.0000000000003127. Epub 2016 Aug 19.

Abstract

Objectives: Our objective was to evaluate the efficacy of probiotics and prebiotics in patients with Parkinson disease (PD) and constipation.

Methods: We conducted a tertiary setting, randomized, double-blind, placebo-controlled trial in patients with PD with Rome III-confirmed constipation based on 2-week stool diary data at baseline. Patients (n = 120) were randomly assigned (2:1) to either a fermented milk, containing multiple probiotic strains and prebiotic fiber, or placebo, once daily for 4 weeks. The primary efficacy endpoint was the increase in the number of complete bowel movements (CBMs) per week. The key secondary endpoints were 3 or more CBMs and an increase by one or more CBMs per week during weeks 3 and 4.

Results: For the primary endpoint, the consumption of a fermented milk containing probiotics and prebiotics resulted in a higher increase in the number of CBMs (mean 1.2, 95% confidence interval [CI] 0.8-1.6) than placebo (0.1, 95% CI -0.4% to 0.6%) (mean difference 1.1, 95% CI 0.4-1.8; p = 0.002). For the key secondary endpoints, a higher number of patients in the probiotics-prebiotics group vs the placebo group reported 3 or more CBMs (p = 0.030; 58.8% vs 37.5%; odds ratio = 2.4, 95% CI 1.1-5.2) and an increase by one or more CBMs (p = 0.004; 53.8% vs 25.0%; odds ratio = 3.5, 95% CI 1.8-8.1) during weeks 3 and 4.

Conclusions: The consumption of a fermented milk containing multiple probiotic strains and prebiotic fiber was superior to placebo in improving constipation in patients with PD.

Clinicaltrialsgov identifier: NCT02459717.

Classification of evidence: This study provides Class I evidence that for patients with PD who have constipation, fermented milk containing probiotics and prebiotics increases the frequency of CBMs.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Animals
  • Constipation / diet therapy*
  • Constipation / etiology
  • Defecation
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Milk*
  • Outpatients
  • Parkinson Disease / complications*
  • Parkinson Disease / diet therapy*
  • Patient Satisfaction
  • Prebiotics / administration & dosage*
  • Prebiotics / adverse effects
  • Probiotics / administration & dosage*
  • Probiotics / adverse effects
  • Severity of Illness Index
  • Tertiary Care Centers
  • Treatment Outcome

Substances

  • Prebiotics

Associated data

  • ClinicalTrials.gov/NCT02459717