Objective: The objective of this systematic review and meta-analysis of published clinical trials is to investigate the probiotics’ efficacy in treating constipation in Parkinson’s patients.

Background: Constipation is a common and persistent non-motor symptom of Parkinson’s disease resulting from disturbance of gut microbiota. Recent studies proposed probiotics for the management of constipation related to PD. A few clinical trials have examined probiotics’ effect in treating constipation in Parkinson’s patients. Previous Systematic reviews and meta-analyses testing the efficacy of probiotics had heterogeneity in their data making them unreliable evidence.

Method: We searched 5 electronic medical databases (PubMed, Cochrane, Web of Science, EBSCO, and Scopus) for randomized control trials published until March 1, 2023. We included RCTs comparing probiotics against placebo, other interventions, or no treatment. The primary outcomes were change in number of bowel movements per week and stool consistency. Relevant studies were included, data were extracted using an online sheet, the quality of clinical trials was assessed using the Cochrane risk of bias tool and we analyzed data using RevMan version 5.4 software.

Results: Four studies were included in the meta-analysis (n=293). Compared to placebo, probiotics improved the number of bowel movements per week (MD=1.03 movements,95% CI [0.72,1.35]), improved stool consistency (MD= 0.69 point, 95% CI [0.4,0.98]), showed a reduction in patient assessment constipation severity score and quality of life (SMD= -0.57, 95% CI [-0.94.-0.20]) and (SMD= -0.62, 95% CI [-0.99.-0.25]) respectively and enhanced patient satisfaction (Risk Ratio= 3.09, 95% CI [1.91,5.00]. Analysis showed no heterogeneity among data.

Conclusion: This systematic review and meta-analysis support the beneficial effect of probiotics in the treatment of constipation in Parkinson’s patients and we recommend conducting further clinical trials comparing probiotics against placebo and other treatment options such as trimebutine.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/probiotics-for-treatment-of-constipation-in-parkinsons-patients-a-systematic-review-and-meta-analysis/