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Irritable bowel syndrome is more prevalent than functional constipation in Parkinson’s disease: Clinical spectrum and changes in gut microbiota

T. Mertsalmi, V. Aho, P.A.B. Pereira, L. Paulin, E. Pekkonen, P. Auvinen, F. Scheperjans (Helsinki, Finland)

Meeting: 2016 International Congress

Abstract Number: 340

Keywords: , ,

Session Information

Date: Monday, June 20, 2016

Session Title: Parkinson's disease: Non-motor symptoms

Session Time: 12:30pm-2:00pm

Location: Exhibit Hall located in Hall B, Level 2

Objective: To assess distal functional gastrointestinal (GI) symptoms and their connection to fecal microbiota (FM) in Parkinson (PD) patients.

Background: The majority of PD patients suffer from GI symptoms of which usually constipation is mentioned as the most prominent. Constipation is one of the strongest risk factors for PD, and recently also irritable bowel syndrome (IBS) was linked to PD. Gut microbiota alterations were recently described in PD. We wanted to assess functional GI symptoms in PD and their possible connection to other non-motor symptoms (NMS) and FM.

Methods: This case-control study compared 74 patients with a diagnosis of PD according to the Queen Square Brain Bank criteria with 75 sex- and age-matched control subjects without any signs of parkinsonism or potential premotor symptoms. The prevalence and overall severity of NMS was assessed using the NMS Questionnaire (NMSQuest). Distal functional GI symptoms were assessed using the Rome III questionnaire. FMs were compared by pyrosequencing of the V1-V3 regions of the bacterial 16S ribosomal RNA gene.

Results: IBS was significantly more prevalent in PD patients than in controls (24.3 % vs. 5.3 %; p=0.001). The most common subtype in PD patients was mixed IBS (IBS-M; 14.9 %). Prevalence of constipation-predominant (IBS-C) and diarrhea-predominant IBS (IBS-D) in PD patients were 6.8 %, and 1.4 %, respectively. In addition, 12.2 % of PD patients and 6.7 % of controls suffered from functional constipation (FC) (p=0.072).

Table 1
  Parkinson (n=74) Control (n=75) p-value
IBS 24.3 % 5.3 % 0.001
IBS-C 6.8 % 2.7 % 0.276
IBS-D 1.4 % 0.0 % 0.497
IBS-M 14.9 % 2.7 % 0.009
FC 12.2 % 4.0 % 0.078
The prevalence of irritable bowel syndrome (IBS) and functional constipation (FC) in Parkinson patients and controls. (IBS-C = constipation predominant, IBS-D = diarrhea predominant, IBS-M = mixed, IBS-U = unsubtyped” PD patients had hard or lumpy stools, straining at defecation, abdominal pain or discomfort, and incomplete emptying of bowels more commonly than decreased bowel frequency. PD patients with IBS (IBS+) also had more other NMSs than PD patients without IBS (IBS-), although there was no difference in motor symptoms. The analysis of FM showed a lower abundance of Prevotella bacteria in IBS+ patients compared to IBS-.

Conclusions: The high prevalence of PD patients who fulfill the criteria for IBS, and IBS-M being the most common subtype indicates that, in addition to constipation, patients may suffer from a broader spectrum of distal GI symptoms. A more systematic assessment of functional GI symptoms could add value to assessment of NMS in PD. The lower abundance of Prevotella bacteria in IBS+ may indicate that microbiota play a role in GI symptoms of PD patients.

To cite this abstract in AMA style:

T. Mertsalmi, V. Aho, P.A.B. Pereira, L. Paulin, E. Pekkonen, P. Auvinen, F. Scheperjans. Irritable bowel syndrome is more prevalent than functional constipation in Parkinson’s disease: Clinical spectrum and changes in gut microbiota [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/irritable-bowel-syndrome-is-more-prevalent-than-functional-constipation-in-parkinsons-disease-clinical-spectrum-and-changes-in-gut-microbiota/. Accessed November 22, 2024.

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