Open AccessMulti-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial
Author(s) -
Azliza Ibrahim,
Raja Affendi Raja Ali,
Mohd Rizal Abdul Manaf,
Norfazilah Ahmad,
Farah Waheeda Tajurruddin,
Wong Zhi Qin,
Siti Hajar Md Desa,
Mohamed Ibrahim Norlinah
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0244680
Subject(s) - medicine , constipation , placebo , probiotic , gastroenterology , odds ratio , randomized controlled trial , lactulose , biology , pathology , alternative medicine , bacteria , genetics
Objective 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. Methods PD patients with constipation (ROME III criteria) were randomized to receive a multi-strain probiotic ( Lactobacillus sp and Bifidobacterium sp at 30 X 10 9 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). Results 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. Conclusion 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.