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Small intestinal bacterial overgrowth in Parkinson's disease
Abstract
Background Recent studies reported a high prevalence of small intestinal bacterial overgrowth (SIBO) in Parkinson's disease (PD), and a possible association with gastrointestinal symptoms and worse motor function. We aimed to study the prevalence and the potential impact of SIBO on gastrointestinal symptoms, motor function, and quality of life in a large cohort of PD patients.Methods 103 Consecutive PD patients were assessed using the lactulose-hydrogen breath test; questionnaires of gastrointestinal symptoms and quality of life (PDQ-39); the Unified PD Rating Scale (UPDRS) including "on"-medication Part III (motor severity) score; and objective and quantitative measures of bradykinesia (Purdue Pegboard and timed test of gait). Patients and evaluating investigators were blind to SIBO status.Results 25.3% of PD patients were SIBO-positive. SIBO-positive patients had a shorter mean duration of PD (5.2 ± 4.1 vs. 8.1 ± 5.5 years, P = 0.007). After adjusting for disease duration, SIBO was significantly associated with lower constipation and tenesmus severity scores, but worse scores across a range of "on"-medication motor assessments (accounting for 4.2-9.0% of the variance in motor scores). There was no association between SIBO and motor fluctuations or PDQ-39 Summary Index scores.Conclusions This is the largest study to date on SIBO in PD. SIBO was detected in one quarter of patients, including patients recently diagnosed with the disease. SIBO was not associated with worse gastrointestinal symptoms, but independently predicted worse motor function. Properly designed treatment trials are needed to confirm a causal link between SIBO and worse motor function in PD.
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In the citing paper
“PD patients suffering from SIBO were not reported to develop worse GI dysfunction.”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Tan et al., 2014
In the citing paper
“Abnormalities of GI motility might increase the occurrence of SIBO which is highly prevalent in PD patients (Brown et al., 2011;Sánchez-Ferro et al., 2015), even in recently diagnosed PD patients (Tan et al., 2014).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Tan et al., 2014
In the citing paper
“However, they were independently predisposed to worse motor-dysfunction (Tan et al., 2014).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Tan et al., 2014
In the citing paper
“As mentioned before, SIBO is highly prevalent in PD (Andrews et al., 2009;Brown et al., 2011) and PD patients that tested positive for SIBO are predisposed to worse motordysfunction (Tan et al., 2014).”
From The Gut-Brain Axis in Parkinson’s Disease: Possibilities for Food-Based Therapies (2017) · cites this paper as Tan et al., 2014
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Metadata
- Authors
- Tan, A. H., Mahadeva, S., Thalha, A. M., Gibson, P. R., Kiew, C. K., Yeat, C. M., Ng, S. W., Ang, S. P., Chow, S. K., Tan, C. T., Yong, H. S., Marras, C., Fox, S. H., & Lim, S.-Y.
- Affiliations
- University of Malaya (MY)
- The Alfred Hospital (AU)
- University of Toronto (CA)
- Corresponding author
- Lim, Shen-Yang
- ORCID
- Venue
- Parkinsonism & Related Disorders
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 20
- Issue
- 5
- Pages
- 535-540
- ISSN
- 1353-8020 (ISSN-L)
- OpenAlex
- W1983564695
- Cited by
- 274
- References
- 34
- Citations by year
- 2026: 8 · 2025: 19 · 2024: 21 · 2023: 24 · 2022: 29 · 2021: 39 · 2020: 34 · 2019: 25 · 2018: 28 · 2017: 20 · 2016: 11 · 2015: 15 · 2014: 1
- FWCI
- 10.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Parkinsonism & Related Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Malaysian Ministry of Higher Education
- Topics
- Health Sciences › Medicine › Clinical Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- small intestinal bacterial overgrowth, Parkinson's disease
- MeSH terms
- Aged, Bacterial Infections, Female, Humans, Hydrogen, Intestinal Diseases, Lactulose, Male, Middle Aged, Parkinson Disease, Quality of Life, Surveys and Questionnaires, Regression Analysis, Severity of Illness Index, Prevalence
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