#Probiotics for Constipation

[123aurasstuff]

Recognizing Typical Stomach Problems

People of all ages are frequently affected by stomach issues. Some may need medical attention, but many are simple and transient issues. The following are some of the most typical stomach problems along with possible causes:

Heartburn and indigestion

Causes include stress, certain drugs, overindulging in hot or fatty foods, and excessive alcohol consumption.

Symptoms include nausea, belching, and a burning feeling in the chest.

Feeling queasy and throwing up

Food poisoning, illnesses, motion sickness, pregnancy, and adverse drug reactions are some of the causes.

Symptoms include nausea, upset stomach, retching, and vomiting.

The diarrhea

Food poisoning, infections, irritable bowel syndrome (IBS), adverse drug reactions, and stress are some of the causes.

Symptoms: Consistent loose stools and cramping in the abdomen.

Constipation

Causes include stress, sedentary lifestyle, drugs, dehydration, and a lack of fiber.

Symptoms include firm, tiny stools that are difficult to pass.

Abdominal Pain

Gas, bloating, indigestion, ulcers, appendicitis, gallstones, and irritable bowel syndrome are some of the causes of abdominal pain.

Symptoms include cramping, soreness, and dull or sharp abdominal pain.

When to Consult a Physician It's crucial to speak with a healthcare provider if you encounter any of the following symptoms: Excruciating stomach pain Stool bleeding, continuous vomiting, inexplicable weight loss, and trouble swallowing

Note: Not every stomach problem that could arise is included in this list. It's best to consult a doctor if your symptoms are severe or chronic.

Home Remedies for Common Stomach Upsets

Home Treatments for Typical Stomach Disorders Although mild symptoms may be relieved by home remedies, they shouldn't be used in place of expert medical guidance. Typical home cures include the following:

Hydration: Consuming copious amounts of liquids, particularly water.

Rest: Steer clear of demanding activities.

A bland diet consists of consuming simple-to-digest meals like rice, bread, and bananas.

Over-the-counter drugs: Antihistamines, antacids, and antidiarrhea agents could aid in symptom relief.

Recall that you must see a doctor for a proper diagnosis and treatment if your symptoms intensify or continue.

[yakultindia]

5 Easy & Effective Home Remedies for Constipation

Constipation is a condition where bowel movements are infrequent or difficult. It can be caused by factors like low fiber intake, dehydration, and lack of physical activity.

[liftednaturalsus]

Embracing Digestive Comfort: The Power of Probiotics for Constipation Relief

Dealing with the discomfort of constipation can cast a shadow over even the brightest of days. At LiftedNaturals.com, we believe that nature has provided us with a solution that can make a world of difference. Introducing the transformative potential of Best Probiotic Constipation relief – a natural approach to supporting your digestive health and overall well-being.

Understanding the Constipation Challenge

Constipation can stem from a variety of factors, including diet, stress, and imbalances in gut health. Our mission is to tackle the root causes and offer a holistic solution that promotes lasting relief:

Restoring Gut Harmony: The gut plays a crucial role in overall health, and our probiotic supplements are meticulously formulated to restore a balanced and harmonious gut environment. This promotes smoother digestion and encourages regular bowel movements.

Optimizing Digestive Function: LiftedNaturals.com probiotics feature carefully selected strains that support optimal digestive function, helping to alleviate discomfort and promote regularity.

Gentle and Natural: Unlike harsh laxatives that can lead to dependency and discomfort, our probiotics offer a gentle and natural way to maintain regularity, without the side effects.

Unlocking the Potential of Probiotics

Experience the relief and support that probiotics can offer to your digestive health and overall well-being:

Tailored Formulas: Choose from our range of probiotic supplements, each formulated to address specific digestive concerns and support your body's natural processes.

Daily Wellness Ritual: Incorporate probiotics into your daily routine to provide ongoing support for your digestive system, helping you feel your best every day.

Quality Assurance: Rest assured that our probiotics are crafted with the highest quality standards, ensuring that you receive the most effective and reliable support possible.

Say Goodbye to Digestive Discomfort Are you ready to say goodbye to the discomfort of constipation and embrace a natural solution for digestive health? LiftedNaturals.com's Probiotics for Constipation offer a gentle yet effective approach to maintaining regularity and promoting overall well-being. Experience the transformative benefits of probiotics and take a step toward improved digestive comfort today. Your journey to a healthier, happier you starts here.

[ratwars]

The face of a baby who is dramatic and stressed and costing me 600 dollars but that is fine.

[marketvibes]

Physician's Choice Probiotics 60 Billion CFU - 10 Strains + Organic Prebiotics - Immune, Digestive & Gut Health - Supports Occasional Constipation, Diarrhea, Gas & Bloating - for Women & Men - 30ct

Max Strength General Purpose Probiotic: Our non-refrigerated probiotic is designed to support digestive health & gut health. A great choice for those looking to support a diverse healthy microbiome w/ 60B CFU - Probiotics for Women & Men alike Support Your Gut: Our probiotic contains 10 diverse high-quality probiotic strains and organic prebiotics - synergistically working together to support your gut health. Expertly crafted to support occasional constipation, diarrhea, gas & bloating! Survives the Gut: From start to finish - this probiotic is designed to survive the gut & maximize the colonization of our strains. We use a shelf-stable bottle, acid-resistant capsules, and 60 Billion Colony forming units (CFU) to achieve this! Backed By Science - Our probiotics are crafted based on scientific research. We have partnered with a network of expert physicians to help review our products & research. We strive to educate & help you with informed decisions regarding your health. Safety Assured Standard of Quality: Our 60B probiotic is 3rd-party tested for purity and potency. Each bottle is manufactured with love & care in the USA with strict quality control - using imported and domestic ingredients.

your chance now to benefit this product

[virtualmosshroom]

Don’t love waking up at 3:00am from a gut ache so painful it has me fighting throwing up while shiddin

[microbzcouk]

Transform Your Health from the Inside Out with Microbz Gut Health

Is your gut feeling off? Discover the science behind gut health and how Microbz probiotics can support a healthy gut microbiome for better digestion, stronger immunity, and a happier you! Dive into the world of gut bacteria and its impact on your health. Learn how Microbz’s probiotic supplements can fortify your digestion, immunity, and vitality.

[discoverybody]

Do Probiotics Cause Constipation

Probiotics' beneficial effects on intestinal health have drawn a lot of attention, yet others have expressed worry about possible negative effects, such as constipation. In order to answer the topic of whether probiotics promote constipation, this article will examine recent scientific research as well as individual differences. Probiotics are live bacteria that enhance immune system and digestion to improve gastrointestinal and general health. Dairy products, fermented meals, and supplements are good sources of them. Probiotics are essential for preserving gut health because they help break down food, absorb nutrients, and combat pathogenic microbes. It's critical to distinguish between prebiotics and probiotics, which are both types of carbohydrates that support the development of beneficial gut flora.

Probiotics can increase bowel movements, which can help with constipation; nevertheless, some people may develop constipation as a result of taking probiotics. By encouraging the growth of good bacteria in the stomach, probiotics may also help reduce gas and bloating, but some people may have more gas and bloating than others. Additionally, they can aid in preventing vaginal yeast infections, though certain women may be more susceptible to certain strains. The efficacy of probiotics in mitigating symptoms of irritable bowel syndrome (IBS), including gas, bloating, and diarrhea, differs throughout persons and strains. It's crucial to speak with a doctor before using probiotics to treat yeast infections or stomach problems. Probiotics can have adverse effects like gas, bloating, and mild gastrointestinal discomfort, even though they are normally safe.

Some people may experience more severe adverse effects, including as allergic responses. Probiotics are usually thought to be safe for both adults and children, but it is important to speak with a healthcare provider before administering them to kids or people who have compromised immune systems or other medical disorders. Probiotics can generally help with digestive issues including gas, bloating, and constipation, but they shouldn't take the place of a balanced diet and way of life. It's critical to be aware of any possible adverse effects and to get medical help when needed.

[gumarabicusa]

To give some background, Sickle cell anemia patients suffer from oxidative stress due to chronic inflammation and self-oxidation of sickle hemoglobin. It is this reality that led many to explore treatment through anti-oxidant influences. While research on the effects of acacia gum specifically in sickle cell anemia is limited, there is some evidence to suggest that certain components found in acacia gum, such as polyphenols and dietary fiber, may have positive effects on blood parameters and overall health. Polyphenols, which are plant compounds with antioxidant properties, have been investigated for their potential to reduce oxidative stress and inflammation associated with sickle cell disease. Dietary fiber, which is highly present in acacia gum, may have a positive influence on gastrointestinal health and gut microbiota. Maintaining a healthy gut microbiome is important for individuals with sickle cell anemia, as they are more prone to infections due to their compromised immune system.

Link to the Study: https://pubmed.ncbi.nlm.nih.gov/28331623/

For additional information: https://www.gumarabicusa.com/gum-arabic-research#gum-arabic-medical-research

#gumarabic #constipation #Nutrition #Nutritionist #eatclean #healthylife #diarrhea #bloating #detox #prebiotics #prebiotic #guthealth #healthygut #superfoods #immunebooster #healthbenefits #nutrients #antiinflammatory #foodasmedicine #probiotics #probiotic #organicfood #immunesystem #immunesupport #nourishyourbody #metabolism #weightmanagement #Loveyourgut #guthealthy #acaciagum #hashabprebiotic #acaciaprebiotic #baobabprebiotic #acaciagum #inulin #hashab #inulinprebiotic #hashab_gum #acacia_senegal #acacia_seyal #dietary_fiber

[smartfoodsolutions-org]

Exploring the Wonders of Probiotics

How They Work and Benefit Our Health

Probiotics, often referred to as “good bacteria,” have gained increasing recognition for their potential to promote health and well-being. These microorganisms, primarily found in certain foods and supplements, play a crucial role in maintaining a balanced and harmonious gut microbiome. This essay delves into the fascinating world of probiotics, elucidating their mechanisms of action and the…

[yogahealth2]

[yakultindia]

5 Easy & Effective Home Remedies for Constipation

Constipation is a common digestive issue characterized by infrequent bowel movements or difficulty passing stools. It can be caused by various factors like low fiber intake, dehydration, lack of physical activity, or certain medications.

[branvine]

The Top Benefits of Using Cat Probiotic Powder

Cat probiotic powder helps promote digestive health by introducing beneficial bacteria to your cat’s digestive system. These bacteria help break down food and absorb nutrients, which is essential for your cat’s overall health.

[aamasumjack-blog]

Top 9 Probiotic Supplements for a Healthy Gut in 2023

Are you searching for a probiotic supplement that meets your specific health needs? Our team of experts has thoroughly researched and tested the best probiotic supplements for various health concerns, including weight loss, allergies, IBS, and general use. While Culturelle is our top pick for overall use, we’ve also identified other options that excel in addressing specific health issues. In this article, we’ll share our recommendations and explain what to look for when choosing a probiotic supplement. Whether you’re a health-conscious consumer or dealing with a specific health condition, our guide can help you make an informed decision on the best probiotic supplement for your needs. Keep reading to find out which probiotic supplements made the cut and why.

Probiotics have gained a lot of attention in recent years for their potential benefits to gut health. These beneficial bacteria can help boost the number of good bacteria in the gut, reduce inflammation, and support a healthy immune system. However, with so many probiotic supplements on the market, it can be difficult to know which ones to choose. In this article, we’ll explore the top probiotic supplements for gut health to help you make an informed decision.

At a glance, Top 9 Probiotic Supplements in 2023 for gut health

Renew Life Ultimate Flora Probiotic

Garden of Life Dr. Formulated Probiotics

Culturelle Daily Probiotic

Hyperbiotics PRO-15 Probiotics

BioSchwartz Advanced Strength Probiotic

Florastor Daily Probiotic Supplement

Align Daily Immune Support Probiotic

Seed Synbiotic

MegaFood MegaFlora Probiotic

What are probiotics?

Probiotics are live microorganisms that can provide health benefits when consumed in adequate amounts. These beneficial bacteria are naturally found in the gut and can help to support digestion, boost the immune system, and even improve mental health. Probiotics are available in supplement form and can be found in a variety of strains and doses.

The science behind probiotics and gut health The gut microbiome is a complex ecosystem of bacteria that plays a crucial role in overall health. When the balance of good and bad bacteria in the gut is disrupted, it can lead to a range of health issues, including digestive problems, inflammation, and even autoimmune diseases. Probiotics work by introducing beneficial bacteria to the gut microbiome, helping to restore balance and support gut health.

What are CFUs?

CFUs stands for “colony-forming units,” which is a measure used to determine the number of viable microorganisms, such as bacteria or yeast, in a sample. In the context of probiotic supplements, CFUs indicate the number of live bacteria or yeast in a serving of the supplement.

The CFU count is an important factor to consider when choosing a probiotic supplement, as a higher CFU count generally indicates a greater concentration of beneficial microorganisms. However, it’s important to note that more CFUs doesn’t necessarily mean a better probiotic supplement. Other factors such as the strains of bacteria or yeast, the viability of the microorganisms, and the supplement’s delivery method also play a significant role in determining the effectiveness of the product.

It’s important to choose a probiotic supplement with a CFU count that is appropriate for your individual needs. For general digestive health, a supplement with a CFU count of 5–10 billion may be sufficient. However, for specific health concerns or after a course of antibiotics, a higher CFU count may be more beneficial.

What Do Probiotics Do?

Probiotics are live microorganisms that can have a beneficial effect on our health when consumed in adequate amounts. They work by colonizing the gut and interacting with the gut microbiome, which is the collection of microorganisms that live in our digestive system.

The gut microbiome plays a vital role in overall health, including digestion, immune function, and even mental health. Probiotics can help promote a healthy gut microbiome by increasing the number of beneficial bacteria and reducing the number of harmful bacteria.

Probiotics can also improve digestion and gut function by helping to break down food and absorb nutrients more efficiently. This can lead to reduced symptoms of digestive issues such as bloating, gas, and constipation.

In addition, certain strains of probiotics have been shown to have specific health benefits, such as improving immune function, reducing inflammation, and even potentially preventing certain diseases.

Health Benefits of Probiotics

Probiotics are known for their potential health benefits, which can vary depending on the specific strains and dosages used. Here are some of the main health benefits associated with probiotics:

Improved digestion: Probiotics can help improve digestion by breaking down food and promoting the absorption of nutrients. They can also reduce symptoms of digestive issues such as bloating, gas, and constipation.

Enhanced immune function: Certain strains of probiotics have been shown to stimulate the immune system and improve its ability to fight off harmful bacteria and viruses. This can help prevent infections and illnesses.

Reduced inflammation: Chronic inflammation has been linked to a range of health problems, including autoimmune diseases and heart disease. Some strains of probiotics have been shown to reduce inflammation in the body, potentially helping to prevent these conditions.

Weight loss: Probiotics may also play a role in weight loss, as they can help regulate appetite and improve the body’s ability to burn fat.

Mental health: The gut microbiome has been linked to mental health, with imbalances in gut bacteria potentially contributing to conditions such as anxiety and depression. Some strains of probiotics have been shown to improve mood and reduce symptoms of anxiety and depression.

Skin health: Probiotics may also have benefits for skin health, as they can help reduce inflammation and improve the skin’s ability to retain moisture.

Side Effects of Probiotics

Probiotics are generally considered safe for most people, but they can sometimes cause side effects, especially when taken in large doses. Here are some of the most common side effects of probiotics:

Digestive issues: Some people may experience digestive issues such as gas, bloating, and diarrhea when taking probiotics, especially when first starting to use them. These side effects are usually mild and tend to go away on their own after a few days.

Allergic reactions: In rare cases, people may experience allergic reactions to probiotics, especially if they have a history of allergies or are taking probiotics derived from allergenic sources such as dairy.

Infections: While probiotics are generally safe, they can sometimes cause infections, especially in people with weakened immune systems or those who are critically ill.

Interactions with medication: Probiotics can sometimes interact with medication, especially antibiotics, and reduce their effectiveness. If you are taking medication, it’s important to talk to your healthcare provider before starting to use probiotics.

Risk for certain populations: While probiotics are generally safe for most people, certain populations such as premature infants, people with immune system disorders, and those with a history of intestinal surgery should be cautious when using probiotics and consult their healthcare provider first.

Should You Take a Probiotic Supplement?

While probiotics can provide a number of health benefits, it’s important to note that they may not be right for everyone. For example, some people with certain health conditions, such as inflammatory bowel disease (IBD), may need to avoid certain strains of probiotics or avoid them altogether.

Additionally, it’s important to keep in mind that the effects of probiotics can vary depending on the individual and the specific strain of bacteria used. Some people may experience little to no benefit from taking probiotics, while others may see significant improvements in their gut health and overall wellbeing.

If you’re considering taking a probiotic supplement, it’s important to do your research and choose a high-quality product from a reputable manufacturer. You may also want to consider working with a healthcare professional who can help guide you in selecting the best probiotic supplement for your individual needs and health goals.

Recommended Dosage for Probiotics

While there is no official recommended dosage for probiotics, some studies have suggested that an effective dose can range from 1 billion to 100 billion colony forming units (CFUs) per day. The dosage may vary based on factors such as the specific strain of probiotic, the individual’s health condition, and the reason for taking the probiotic supplement. It’s important to follow the recommended dosage guidelines provided by the manufacturer and consult with a healthcare professional if you have any concerns or questions about dosage. Additionally, it’s important to note that taking excessively high doses of probiotics may result in digestive discomfort, such as bloating or diarrhea.

What’s the Difference Between Probiotics and Prebiotics?

While probiotics and prebiotics are different, they can work together to promote a healthy gut. Prebiotics serve as food for the beneficial bacteria in your gut, while probiotics are the actual live microorganisms that colonize your gut and provide various health benefits.

Consuming both prebiotics and probiotics can help to create a healthy balance of bacteria in your gut and improve overall gut health. Prebiotic foods such as asparagus, artichokes, and bananas can be easily incorporated into your diet, while probiotics can be consumed through fermented foods like yogurt, kefir, and sauerkraut or through supplements.

How we chose the best probiotic supplements

Probiotic strains and CFUs are important factors to consider when choosing a probiotic supplement. CFUs, or colony-forming units, are a measure of the number of viable bacteria in a probiotic product. Some research suggests that a minimum of 1 billion CFUs per day is necessary to see a beneficial effect, but the optimal dose may vary depending on the specific strain and the health condition being targeted.

Different strains of probiotics have different effects on the body, so it’s important to choose a supplement that contains strains that have been shown to be effective for your specific health concern. For example, Lactobacillus and Bifidobacterium are two common genera of probiotics that have been studied extensively for their benefits in gut health.

It’s also important to consider the delivery method of the supplement. Capsules, powders, and gummies are all common forms of probiotic supplements, but some delivery methods may be more effective than others depending on the strain and the individual’s digestive system. For example, some strains may require an enteric-coated capsule to survive the acidic environment of the stomach and reach the small intestine where they can have the greatest impact.

Our team of experts picks for the top probiotic supplements

Renew Life Ultimate Flora Probiotic:

Renew Life Ultimate Flora Probiotic is one of the most popular and effective probiotic supplements available in the market. This supplement contains 50 billion live cultures of 12 different strains of bacteria, including Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus plantarum.

Renew Life Ultimate Flora Probiotic helps to promote digestive and immune health, alleviate constipation and diarrhea, and reduce inflammation. This supplement is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

Garden of Life Dr. Formulated Probiotics:

Garden of Life Dr. Formulated Probiotics is another popular and effective probiotic supplement. This supplement is formulated by Dr. David Perlmutter, a board-certified neurologist and expert in the field of probiotics.

Garden of Life Dr. Formulated Probiotics contains 50 billion live cultures of 16 different strains of bacteria, including Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus plantarum. This supplement helps to improve digestive and immune health, support mental clarity and brain function, and promote overall wellbeing.

Culturelle Daily Probiotic:

Culturelle Daily Probiotic is a top-rated probiotic supplement that contains 10 billion live cultures of Lactobacillus rhamnosus GG, one of the most extensively studied probiotic strains.

Culturelle Daily Probiotic helps to improve digestive health, support immune function, and reduce the risk of antibiotic-associated diarrhea. This supplement is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

Hyperbiotics PRO-15 Probiotics:

Hyperbiotics PRO-15 Probiotics is a high-potency probiotic supplement that contains 15 billion live cultures of 15 different strains of bacteria, including Lactobacillus acidophilus, Bifidobacterium bifidum, and Streptococcus thermophilus.

Hyperbiotics PRO-15 Probiotics helps to improve digestive health, boost immune function, and alleviate constipation and diarrhea. This supplement is vegetarian, non-GMO, and free of gluten, lactose, and soy.

BioSchwartz Advanced Strength Probiotic:

BioSchwartz Advanced Strength Probiotic is a potent probiotic supplement that contains 40 billion live cultures of 11 different strains of bacteria, including Lactobacillus acidophilus, Bifidobacterium lactis, and Lactobacillus plantarum.

BioSchwartz Advanced Strength Probiotic helps to improve digestive health, support immune function, and reduce inflammation. This supplement is vegetarian, non-GMO, and free of gluten, dairy, and soy.

Florastor Daily Probiotic Supplement:

Florastor Daily Probiotic Supplement is a unique probiotic supplement that contains Saccharomyces boulardii, a non-pathogenic yeast that has been shown to improve digestive health and prevent diarrhea.

Florastor Daily Probiotic Supplement helps to support digestive health, boost immune function, and alleviate symptoms of irritable bowel syndrome. This supplement is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

Align Daily Immune Support Probiotic:

Align Daily Immune Support Probiotic is a popular probiotic supplement that contains 10 billion live cultures of Bifidobacterium lactis, a strain that has been shown to improve gut health and boost immune function.

Align Daily Immune Support Probiotic helps to improve digestive health, support immune function, and reduce the risk of digestive issues related to stress. This supplement is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

Seed Synbiotic:

Seed Synbiotic is a high-quality probiotic supplement that contains a combination of probiotic strains and prebiotic fibers. This supplement is designed to provide a complete solution for gut health and overall wellbeing.

Seed Synbiotic contains 24 probiotic strains, including Lactobacillus acidophilus, Bifidobacterium lactis, and Streptococcus thermophilus, as well as prebiotic fibers such as inulin and pectin. This supplement helps to improve digestive health, boost immune function, and support overall wellbeing. Seed Synbiotic is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

MegaFood MegaFlora Probiotic:

MegaFood MegaFlora Probiotic is a high-quality probiotic supplement that contains 50 billion live cultures of 14 different strains of bacteria, including Lactobacillus acidophilus, Bifidobacterium bifidum, and Lactobacillus plantarum.

MegaFood MegaFlora Probiotic helps to improve digestive health, boost immune function, and support overall wellbeing. This supplement is gluten-free, dairy-free, and soy-free, making it suitable for people with dietary restrictions.

Conclusion:

Probiotic supplements have become increasingly popular in recent years due to their potential health benefits. There are many different probiotic supplements available in the market, each with its own unique features and benefits. When choosing a probiotic supplement, it’s important to consider factors such as strain diversity, CFU count, quality, price, and form. By choosing the right probiotic supplement, you can help to improve your digestive health, boost your immune function, and support overall wellbeing. Remember to consult with your healthcare provider before starting any new supplement regimen.

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[longhaulerbear]

The classical symptoms of PD are characterized by progressive motor dysfunction, including rest tremor, bradykinesia, rigidity, and postural instability, which is noticeable when there is already 60% dopaminergic neuronal loss in the substantia nigra.

In addition to motor symptoms, non-motor manifestations such as rapid eye movement sleep behavior disorder (RBD), gastrointestinal dysfunction, olfactory disruption, neuropsychiatric symptoms, and sensory dysfunction also exist in patients with PD and compromise their quality of life.5 Of note, these non-motor PD symptoms can occur years before the onset of classical motor symptoms.6 Thus, they are therefore now considered prodromal clinical markers before the onset of the classical motor manifestations, according to the International Movement Disorders Society.7 Among these prodromal symptoms, constipation is the most prevalent and earliest pre-motor feature and can precede motor symptoms by decades.

The pathological hallmark of PD is progressive dopaminergic neuronal degeneration and intraneuronal accumulations of misfolded α-synuclein (Lewy bodies) in the substantia nigra.3 The pathological α-synuclein can transmit from cell to cell in a prion-like fashion to promote the neurodegenerative process of this disease.9,10 Recent postmortem evidence indicates that Lewy body pathology is first detectable outside the brain, starting from neurons in the gut enteric nervous system (ENS) and olfactory bulbs.11 These neuropathology observations are consistent with the findings that non-motor symptoms of PD, especially constipation, can precede the onset of motor symptoms.8 Further in vivo PD animal model studies demonstrated that pathological forms of α-synuclein, after injection into the intestinal wall, can be transported from the gut to the brain via the vagus nerve, reaching the dorsal motor nucleus of the vagus nerve in the brainstem.12, 13, 14 However, although this pathology finding has given rise to the idea that PD pathology originates in the peripheral ENS and then invades the brain via retrograde axonal transport through the vagus nerve, a small fraction of patients do not show pathology in the ENS. In about one-third of patients, the PD neuropathology begins in the brain itself and then travels downward.15 Hence, it is hypothesized that PD can be divided into a gut-first (body first) and a brain-first subtype.15 The former is tightly associated with chronic constipation and RBD during the prodromal phase and the latter is most often sparing of gastrointestinal symptoms and is RBD-negative during the prodromal phase. These findings reinforce the concept that PD is a heterogeneous disorder with diverse initial triggers and propagation trajectories of α-synuclein, suggesting that tailored disease-modifying therapy is needed for patients with different subtypes.

The various recently observed gut microenvironmental changes in the early stages of the disease may play a vital role in PD, especially those with the body-first subtype of the disease. Patients whose disease begins in the gut may benefit most from interventions that target the gut. In this review, we summarize recent evidence for altered gut microenvironments contributing to PD through the gut–brain axis. Furthermore, there is a plethora of evidence, including our previous study, for altered gut microbiota in patients with PD compared with unaffected controls.

There is much evidence that the vagus nerve transports α-synuclein from the gut to the brain.12 Pathological α-synuclein fibrils injected into the duodenum can move from the muscular layer of the duodenum to the brain and then from neuron to neuron across the synapses through the vagus nerve in a PD animal model.12 Furthermore, recent evidence indicates that protein nucleation and aggregation may be influenced by E. coli's secretion of curli, which induces neuronal deposition of α-synuclein in the ENS.29,31 The abundance of E. coli at the colonic mucosa correlates with enteric α-synuclein deposition in PD patients.

A plethora of studies have investigated changes in the gut microbiota in patients with PD compared with healthy controls using either 16 S rRNA gene amplicon surveys or shotgun metagenomic sequencing analysis.35, 36, 37, 38, 39, 40, 41, 42 Meta-analyses have shown that the relative abundance of various phyla of anti-inflammatory and short-chain fatty acid (SCFA)-producing bacteria, including Blautia, Coprococcus, Roseburia, Lachnospira, Fusicatenibacter, and Faecalibacterium, are reduced in PD patients compared with controls. In contrast, the amounts of Lactobacillus, Bifidobacterium, and Akkermansia are higher in PD patients than in unaffected participants from different ethnicities.38, 39, 40, 41 Notably, opportunistic pathogens and pro-inflammatory bacteria at the phylum level, including Corynebacterium, Porphyromonas, Alistipes, Bacteroides, Escherichia, and Megasphaera, are also enriched in PD.40,43 In metagenomic research, gene markers from the gut microbiome were found to accurately discriminate PD patients from healthy controls, with most of the identified markers belonging to Bacteroides and Escherichia species.44 Although PD medications affect the structure of the gut microbiota, these changes are detectable in drug-naïve early-stage PD patients.36,43,45

Changes in the gut microbiota also correlate with disease progression in PD. A decrease in the SCFA-producing microbiota and increase in pro-inflammatory bacteria correlate with motor and cognitive severity in patients with PD.38,40,46 Compared with transplantation of fecal gut microbiota from healthy donors, such transplantation from PD patients leads to worsened motor symptoms in a transgenic rodent model of PD.47 A 3-year longitudinal follow-up study of PD patients revealed that a reduced amount of Roseburia species predicted faster progression of both motor and non-motor symptoms of PD.48 A lower abundance of SCFA-producing bacteria, including Fusicatenibacter and Faecalibacterium, correlates with elevated fecal inflammatory calprotectin levels in PD patients.49 Furthermore, enrichment in Bacteroides and Bifidobacterium has been linked to elevated expression of systemic and fecal inflammatory markers IFN-γ, TNF-α, and neutrophil gelatinase-associated lipocalin in patients with PD.42,50 The increased levels of Lactobacillaceae and Bifidobacteriaceae in PD patients require further investigation, as they are usually recognized as probiotics for improving constipation.51 Therefore, distinct gut microbiota species promote enteric α-synuclein aggregation or gut inflammation to facilitate the occurrence and progression of PD.

The composition of gut microbiota also influences the pharmaceutical treatment responses in PD patients. The growing literature has shown the role of the gut microbiome in the pharmacokinetics of prescription drugs and the effects that the drugs can have in turn on the composition of the gut microbiome,52,53 indicating a potential interaction between PD medications and the microbiome. Prior studies have shown that anti-PD medications, including catechol-O-methyl transferase (COMT) inhibitors and anticholinergics, have gastrointestinal side effects, which may be related to the changes of the gut microbiome.54,55 Furthermore, bacterial tyrosine decarboxylase, which can convert levodopa to dopamine, could limit its bioavailability and may contribute to the interindividual responses to levodopa treatment among patients with PD.56,57 Enterococcus faecalis was found to be the dominant microorganism responsible for levodopa decarboxylation and restrict levels of levodopa in the treatment of PD.57 Dopamine produced by gut bacterial metabolism of levodopa decarboxylation can also impair intestinal motility, which could provide an explanation for bacterial overgrowth in the small intestine associated with motor fluctuation in PD.58 These observations lend support to the notion that the composition of the gut microbiome may affect the treatment efficacy and potential side effects of levodopa treatment in patients with PD.

Srivastav et al. treated animals with an oral probiotic mixture containing Lactobacillus rhamnosus GG, Bifidobacterium animalis lactis, and Lactobacillus acidophilus for 30 days, after which the mice were given MPTP injections.62 The results showed that mice receiving this probiotic mixture reduced dopaminergic neurodegeneration by upregulating neurotrophic factors and increasing striatal neuronal responses to dopamine.62 Using the same toxin-induced PD model, Liao et al. fed mice with Lacobacillus plantarum PS128 for 28 days, then gave them MPTP injections for 4 days. The results showed that feeding with Lacobacillus plantarum PS128 mitigated neuronal degeneration, attenuated oxidative stress and neuroinflammation, and rescued the locomotor defects of MPTP-injected PD mice.63 Sun et al. treated MPTP-injected mice with the probiotic Clostridium butyricum for 4 weeks and demonstrated improved motor deficits, attenuated dopaminergic neuron loss, improved synaptic dysfunction, and reduced microglia activation in the treated mice.64 This beneficial effect was associated with increased colonic levels of glucagon-like peptide-1 (GLP-1), colonic G protein–coupled receptors GPR41/43, and other components of the cerebral GLP-1 receptor pathway.57 Of note, the incretin hormone GLP-1 was recently found to regulate neurogenesis and synaptic plasticity,65 and GLP-1 agonists may be neuroprotective in PD pathogenesis.66 Similarly, a 3-week treatment with Lactobacillus fermentum U-21 reduced nigra dopaminergic cell loss in a paraquat-toxin model of PD.67

Several studies have demonstrated the potential benefits of probiotic supplementation in patients with PD. A total of seven clinical trials were identified, which were all randomized clinical trials68, 69, 70, 71, 72, 73, 74 (Table 1). Consumption of fermented milk containing multiple probiotic strains can improve constipation in patients with PD.62 Similar beneficial effects in improving bowel movements were also noted in PD patients in most of the probiotic clinical trials.51,73 Evidence seems to demonstrate that probiotic intake can improve bowel movement and reduce gastrointestinal symptoms. There are two studies measuring non-gastrointestinal symptoms of PD as one of the primary outcomes of probiotic clinical trials.71,74 Probiotic supplementation containing Bifidobacterium bifidum, L. acidophilus, L. fermentum and Lactobacillus reuteri for a period of 12 weeks has been observed to improve some symptoms in PD patients as measured by total MDS-UPDRS scores.71

One recent open-label clinical trial with 87 participants showed improvement of non-motor symptom scores, reduced fecal inflammatory marker of calprotectin and increased fecal butyrate in patients with PD who received prebiotic supplement with resistant starch compared to those without prebiotic intervention.78 Several in vivo studies have shown that lower abundance of SCFAs butyrate-producing bacteria could be corrected by the administration of prebiotic fibers, which in turn reduce the gut inflammatory processes, improve gut barrier function, and peristalsis.79,80 SCFAs have a key role in modulating the cross-talks in the gut–brain axis through modulating the gut barrier and blood–brain barrier integrity, inflammatory processes, inhibition of histone deacetylase to promote neuronal survival.81 Of note, an in vivo study using a transgenic a-synuclein–expressing mouse model demonstrated that a germ-free environment eliminates PD phenotypes but that oral feeding with SCFAs remerged the disease-related neuropathology by microglial activation.82 As the effects of SCFAs may depend on the concentration and the different subtypes, the effect of SCFAs in the PD process requires more studies.