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

• Published in: PloS one 2020-12, Vol.15 (12), p.e0244680-e0244680
• Main Authors: Ibrahim, Azliza, Ali, Raja Affendi Raja, Manaf, Mohd Rizal Abdul, Ahmad, Norfazilah, Tajurruddin, Farah Waheeda, Qin, Wong Zhi, Desa, Siti Hajar Md, Ibrahim, Norlinah Mohamed
• Format: Article
• Language: English
• Subjects: 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
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0244680

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 p5 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.