More than constipation - bowel symptoms in Parkinson's disease and their connection to gut microbiota

Eur J Neurol. 2017 Nov;24(11):1375-1383. doi: 10.1111/ene.13398. Epub 2017 Sep 11.

Abstract

Background and purpose: The majority of Parkinson's disease (PD) patients suffer from gastrointestinal symptoms of which constipation is considered the most prominent. Recently, in addition to constipation, a diagnosis of irritable bowel syndrome (IBS) was also found to be associated with increased PD risk. Gut microbiota alterations have been reported in IBS and recently also in PD. IBS-like bowel symptoms in PD and their possible connection to other non-motor symptoms and faecal microbiota were assessed.

Methods: This case-control study compared 74 PD patients with 75 controls without any signs of parkinsonism or potential premotor symptoms. IBS-like symptoms were assessed using the Rome III questionnaire. The non-motor symptoms were assessed using the Non-Motor Symptoms Questionnaire and Non-Motor Symptom Scale. Faecal microbiota were assessed by pyrosequencing of the V1-V3 regions of the bacterial 16S ribosomal RNA gene.

Results: Symptoms that were IBS-like were significantly more prevalent in PD patients than in controls (24.3% vs. 5.3%; P = 0.001). Criteria for functional constipation were met by 12.2% of PD patients and 6.7% of controls (P = 0.072). PD patients with IBS-like symptoms had more non-motor symptoms and a lower faecal abundance of Prevotella bacteria than those without IBS-like symptoms.

Conclusion: Our results indicate that PD patients may suffer from colonic dysfunction beyond pure constipation. Therefore, a more comprehensive assessment of bowel symptoms could provide valuable information. The lower abundance of Prevotella bacteria in PD patients with IBS-like symptoms suggests that the microbiota-gut-brain axis may be implicated in the gastrointestinal dysfunction of PD patients.

Keywords: Parkinson's disease; constipation; irritable bowel syndrome; microbiota; non-motor symptoms.

MeSH terms

  • Aged
  • Case-Control Studies
  • Constipation / complications*
  • Constipation / microbiology
  • Constipation / physiopathology
  • Feces / microbiology*
  • Female
  • Gastrointestinal Microbiome*
  • Humans
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / microbiology
  • Irritable Bowel Syndrome / physiopathology
  • Male
  • Middle Aged
  • Parkinson Disease / complications*
  • Parkinson Disease / microbiology
  • Parkinson Disease / physiopathology
  • Surveys and Questionnaires