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Old 10-20-2015, 07:15 AM
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Default Parkinsonís Disease and Gut Bacteria: A Proven Link

By my favorite Naturopath, Case Adams. Please go to the link, at the bottom, to follow up on References.

Certainly Parkinsonís disease is a brain condition, right? A neurological condition, yes? Whatís that got to do with the gut, you ask?

Since the early 1990s, medical scientists began to link Parkinsonís disease with gut conditions. It was then that researchers from the University of Nebraska Medical Center published a paper in the medical journal Neurology after finding numerous Parkinsonís cases where there were gastrointestinal issues, including constipation, nausea, gut inflammation, acid reflux and other GI issues.

Continuing clinical examinations of Parkinsonís patients at the University of Nebraskaís Medical Center found that the motor conditions related to Parkinsonís disease correlated with problems with the vagus nerve, the rectum and the pelvic floor. The vagus nerve runs from the brain to the gut.

These studies also identified dopamine receptors within with lower esophageal sphincter Ė which opens and closes the stomach to food.

In 2011, research from the University of Tennessee Health Science Center picked up this association between Parkinsonís and the gut. They found additional correlations with digestion, salivation issues and rectum problems, along with the other symptoms found earlier. The research also discussed a condition called gastroparesis Ė where the stomach doesnít empty properly.

As GI problems like these began to become increasingly associated with gut issues, the search turned to whether Parkinsonís may be associated with problems with gut bacteria.

Unhealthy microbiome linked to Parkinsonís
In 2015, research from the Department of Neurological Sciences at the University of Helsinki Ė along with doctors at the University Central Hospital Ė decided to study the bacteria of Parkinsonís patients and compare them with healthy patients.

The researchers investigated gut bacteria among 72 Parkinsonís patients along with 72 healthy human control subjects. The scientists analyzed the feces of each of the subjects and ran sequencing scans in order to determine the genetics of their microbiome.

A microbiome is the cumulative genetic contents of a personís intestinal bacteria as gauged through the analysis of feces. It determines the overall type of species that are inhabiting the gut.

Over the years, microbiologists have been tracking these different species to determine whether they are healthy or disease-causing. Healthy bacteria are called probiotics, while disease-causing bacteria are often called pathobiotics, or pathogenic bacteria.

At any rate, the Swedish researchers analyzed the microbiomes of the healthy people and compared them with the people with Parkinsonís disease to see if there were any differences.

The results were surprising. The scientists found that on average Parkinsonís disease patients had about 23 percent less Prevotella species compared with the healthy subjects. They also found that those with fewer Prevotella species had significantly higher incidence of Parkinsonís.

Prevotella species have been associated in other research with healthy gut bacteria.

The research also found that the Parkinsonís patients had significantly more bacteria in the Enterobacteriaceae family. The Enterobacteriaceae family includes disease-causing bacteria such as Escherichia coli, Yersinia pestis, Klebsiella, Citrobacter, Shigella, Proteus, Salmonella, Enterobacter and Serratia species of bacteria. These cause a myriad of diseases throughout the digestive tract and around the body.

But to Parkinsonís disease too?
The link between the gut and the brain is no longer that big of a reach. For years, scientists have been investigating the gut-brain axis connection. Many mood-related and neurological conditions have now been linked with gut bacteria.

Other research has found that probiotic bacteria can increase levels of important neurotansmitters such as dopamine and serotonin. More specifically, a reduction of dopamine and its related norepinephrine is one of the hallmark symptoms of Parkinsonís disease. When there isnít enough dopamine to provide smooth nerve impulses between the parts of the brain that control motor movement, coordination and motor control begin to deteriorate.

One of the greatest suppliers of dopamine within the brain is the substantia nigra. During the progression of Parkinsonís, neurons in this part of the brain are damaged, which decreases the availability of dopamine. This damage is often related to the existence of Lewy bodies within these areas Ė so it is assumed Lewy bodies are involved in the progression of Parkinsonís.

I might add that University of Nebraska researchers also linked increased levels of Lewy bodies with increased pathogenic bacteria in the gut.

SIBO and Parkinsonís
The enemies of probiotics are the pathogenic bacteria, which fight for territory within the gut. When the pathogenic bacteria win this competition, it often results in what medical researchers call SIBO Ė small intestine bacteria overgrowth.

In 2011, researchers from Romeís Catholic University of Sacred Heart studied 48 Parkinsonís patients along with 36 healthy control human subjects. They found that while only a little over 8 percent of the healthy controls had clear evidence of small intestine bacteria overgrowth, over 54 percent of the Parkinsonís patients had clear evidence of SIBO.

Not everyone with a prevalence of pathogenic bacteria will test positive for SIBO. This is because SIBO symptoms depend largely upon the condition of the gut and the existence of different bacteria species, along with diet and other factors.

This means that it is likely that while half of the Parkinsonís patients had SIBO, many more of the Parkinsonís patients likely had gut bacteria problems or imbalances Ė as indicated by the microbiome research mentioned above.

Can Parkinsonís disease be treated with probiotics?
Yes. This has recently been proven. But to what degree will it make a difference? Some laboratory research using probiotics has shown improved brain tissue protection and decreased inflammation among brain tissues. But long-term clinical studies on human subjects have been limited. One study, for example, tested 40 Parkinsonís patients with supplementing probiotics for a mere five weeks. But this study was limited to treating their Parkinsonís-related constipation.

The researchers reported the probiotics increased their healthy bowel movements.

Besides, it is pretty unlikely that probiotic supplementation for a few weeks will make any significant impact. The condition takes years of progressive damage to brain neurons. These have been associated with toxins and free radical damage within the brain Ė as I showed in this article.

The question now is whether a few years of significant probiotic treatment could help decrease the symptoms Ė or at least slow the progression of this condition.

At the very least we know that probiotic supplementation will help the Parkinsonís patient improve bowel movement consistency and frequency Ė and possibly eliminate the constipation associated with Parkinsonís.

Edwards LL, Quigley EM, Pfeiffer RF. Gastrointestinal dysfunction in Parkinsonís disease: frequency and pathophysiology. Neurology. 1992 Apr;42(4):726-32.

Byrne KG, Pfeiffer R, Quigley EM. Gastrointestinal dysfunction in Parkinsonís disease. A report of clinical experience at a single center. J Clin Gastroenterol. 1994 Jul;19(1):11-6.

Pfeiffer RF. Gastrointestinal dysfunction in Parkinsonís disease. Parkinsonism Relat Disord. 2011 Jan;17(1):10-5. doi: 10.1016/j.parkreldis.2010.08.003.

Pfeiffer RF. Gastrointestinal dysfunction in Parkinsonís disease. Clin Neurosci. 1998;5(2):136-46.

Scheperjans F, Aho V, Pereira PA, Koskinen K, Paulin L, Pekkonen E, Haapaniemi E, Kaakkola S, Eerola-Rautio J, Pohja M, Kinnunen E, Murros K, Auvinen P. Gut microbiota are related to Parkinsonís disease and clinical phenotype. Mov Disord. 2015 Mar;30(3):350-8. doi: 10.1002/mds.26069.

Gabrielli M, Bonazzi P, Scarpellini E, Bendia E, Lauritano EC, Fasano A, Ceravolo MG, Capecci M, Rita Bentivoglio A, Provinciali L, Tonali PA, Gasbarrini A. Prevalence of small intestinal bacterial overgrowth in Parkinsonís disease. Mov Disord. 2011 Apr;26(5):889-92. doi: 10.1002/mds.23566.

Mulak A, Bonaz B. Brain-gut-microbiota axis in Parkinsonís disease. World J Gastroenterol. 2015 Oct 7;21(37):10609-20. doi: 10.3748/wjg.v21.i37.10609.

Tan AH, Mahadeva S, Thalha AM, Gibson PR, Kiew CK, Yeat CM, Ng SW, Ang SP, Chow SK, Tan CT, Yong HS, Marras C, Fox SH, Lim SY. Small intestinal bacterial overgrowth in Parkinsonís disease. Parkinsonism Relat Disord. 2014 May;20(5):535-40. doi: 10.1016/j.parkreldis.2014.02.019.

Divyashri G, Krishna G, Muralidhara M, Prapulla SG. Probiotic attributes, antioxidant, anti-inflammatory and neuromodulatory effects of probiotic Enterococcus faecium CFR 3003: In vitro and in vivo evidences. J Med Microbiol. 2015 Oct 7. doi: 10.1099/jmm.0.000184.

Cassani E, Privitera G, Pezzoli G, Pusani C, Madio C, Iorio L, Barichella M. Use of probiotics for the treatment of constipation in Parkinsonís disease patients. Minerva Gastroenterol Dietol. 2011 Jun;57(2):117-21.

Barboza JL, Okun MS, Moshiree B. The treatment of gastroparesis, constipation and small intestinal bacterial overgrowth syndrome in patients with Parkinsonís disease. Expert Opin Pharmacother. 2015 Sep 16:1-16.

- Jim

"The best and most beautiful things in the world cannot be seen or even touched ó they must be felt with the heart." ó Helen Keller
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Old 07-04-2016, 04:50 PM
schwad01 schwad01 is offline
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Default Parkinsons-- gut-brain connection

Increasing literature points to a significant connection between the bowel land PD- for instance constipation often precedes PD by years--and bowel bacterial flora are often "different" in Parkinson's patients

In PD -there is an increased prevalence of
SIBO-small bowel bacterial overgrowth--this can lead to lactose intolerance as well as impair medication absorption from the gut----- there is no question that based on the color of my urine (entacapone)-- I am not absorbing as much stalevo as before

Since I took a course of antibiotics- I seem to have developed lactose intolerance- when I eat ice cream/cheese late--next day motor-wise is definitely worse- and overall i am worse since the antibiotics

I definitely do better- on a predominantly fruit-veg diet

There is some evidence that probiotics- can both help treat SIBO as well as have some impact on PD motor fluctuations

I know that when I am constipated or if i have more flatulance in the am ( TMI) - i will have a worse day

Th question is what-to-do--for now--

I will check for and treat (will try without antibiotics) H. Pyelori-- the bacteria that is responsible for a significant percentage of stomach inflammation and ulcer-- broccoli seems to be the best single non-antibiotic agent-- usually takjes 3 antibiotics

Eat mostly fruits/vegatables

Research more-ask about the ideal probiotic in PD--one that will help CIBO as well as restore flora that is often deficient in PD==e.g PD patients have less Prevotella Species and more lactobacillus--

Does anyone have similar experiences or knowledge--especially in terms of which probiotic to take?
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