Prebiotics and SCFA Alleviate Parkinson's-Related Constipation: Results from a Randomized Controlled Trial

Constipation is a prevalent and clinically significant non-motor symptom in Parkinson's disease (PD), affecting up to 90% of patients and often preceding motor dysfunction by several years. Imbalance in the gut microbiota and reduced short-chain fatty acid (SCFA) production potentially contribute to PD pathogenesis and symptom onset. This study aimed to determine whether supplementation with SCFAs, the prebiotic 2-fucosyllactose (2-FL), or their combination alleviates constipation and improves the quality of life of individuals with PD.

In a double-blind, randomized, parallel-group clinical trial, 72 patients with PD were assigned to either SCFA, 2-FL, or combined supplementation groups for 6 months. Constipation and quality of life were assessed using the Cleveland Clinic Constipation Score, Bristol Stool Scale, and Patient Assessment of Constipation-Quality of Life, alongside routine neurological evaluation and physical activity questionnaires.

2-FL and combined supplementation significantly reduced constipation severity after 6 months, with the combination yielding the most pronounced and sustained benefits concerning stool consistency, defecation frequency, and patient-reported outcomes. Physical activity remained unchanged and did not affect constipation-related outcomes.

Combined prebiotic and SCFA supplementation effectively alleviate constipation symptoms in patients with PD and improves patient quality of life. Future research should assess the long-term implications and potential disease-modifying effects.

The study was retrospectively registered with the German Clinical Trials Register (DRKS) under the identifier DRKS00027061 on 19 November 2021 ( https://drks.de/search/en/trial/DRKS00027061/details ).