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

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

Author information

1
From the Parkinson Institute (M.B., C.B., E. Cassani, L.I., C. Pusani, G. Pinelli, G. Privitera, I.C., S.A.F., G. Pezzoli), ASST G. Pini-CTO, ex ICP, Milan; Parkinson and Movement Disorders Unit (C. Pacchetti), IRCCS Istituto Neurologico Mondino, Pavia; and Nutrition and Dietetics Service (R.C., E. Cereda), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
2
From the Parkinson Institute (M.B., C.B., E. Cassani, L.I., C. Pusani, G. Pinelli, G. Privitera, I.C., S.A.F., G. Pezzoli), ASST G. Pini-CTO, ex ICP, Milan; Parkinson and Movement Disorders Unit (C. Pacchetti), IRCCS Istituto Neurologico Mondino, Pavia; and Nutrition and Dietetics Service (R.C., E. Cereda), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. e.cereda@smatteo.pv.it.

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.

PMID:
27543643
DOI:
10.1212/WNL.0000000000003127
[Indexed for MEDLINE]

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