Laxatives may slow worsening rigidity in Parkinson's disease

Flexor rigidity increased by 5.5% each year but plateaued in patients who began taking laxatives, even if they weren’t receiving anti-PD medication. A similar pattern was seen with bulk, osmotic and enterokinetic laxative classes, pointing to a common mechanism.

pharmaceutical-journal.com/...

[fwes]

Interesting, BUT science?? or faux-science??

1. Clearly not a double blind study.

2. They have a weakly established correlation, seeking an explanation.

From their report: "The team retrospectively studied 79 PD patients attending a gut-brain axis clinic over 374 person-years. Flexor rigidity increased by 5.5% each year but plateaued in patients who began taking laxatives, even if they weren’t receiving anti-PD medication. A similar pattern was seen with bulk, osmotic and enterokinetic laxative classes, pointing to a common mechanism. "

79 subjects spread over 3 laxative classes avrg. of 26 per class with no controls! Maybe 13 per class if you want to distinguish between patients on from those not on PD meds!

The Fischer z-test suggests 400 independently selected subjects for ONE DIGIT of accuracy in the estimation of a correlation coefficient.

This may be an interesting hint, but it is hardly science.

[johntPM in reply to fwes]

fwes,

Thank you for raising the importance of a correct statistical analysis before jumping to any conclusions.

I suppose it depends how you define "science", but I think this is a useful bit of research, both in method and result. Certainly, further research is needed, but nevertheless in my opinion this is still good science.

You write that:

"The Fischer z-test suggests 400 independently selected subjects for ONE DIGIT of accuracy in the estimation of a correlation coefficient."

Judging from the Table 1 found in [1] such high values are required only when you are trying to show the true correlation is close to 0. For instance, to find a 95% confidence interval to show r is between 0 and 0.2 (that is a r of 0.1, with a half width of 0.1) requires a sample size of 378, whereas to show r is more than 0.1 requires a sample size of only 13.

But why concentrate on correlation? As I see it, the important thing that we, as potential users of this therapy, need to know is what is the probability that someone will be harmed by this treatment.

Reference:

[1] "Sample size estimation for correlations with pre-specified confidence interval"

Murray Moinester, Ruth Gottfried

TQMP, vol 10, no 2.

tqmp.org/RegularArticles/vo...

John

[silvestrov]

Psyllium Husk (Isabgol) (Plantago Ovata) 200g - Natural Laxative - Great Remedy for Constipation, Diarrhoea & Weight Loss

amazon.co.uk/Psyllium-Husk-...

A randomised clinical trial to evaluate the effects of Plantago ovata husk in Parkinson patients: changes in levodopa pharmacokinetics and biochemical parameters

Conclusions

"Plantago ovata husk administration caused a smoothing and homogenization of levodopa absorption, providing more stable concentrations and final higher levels, resulting in a great benefit for patients."

bmccomplementalternmed.biom...

[lempa_nik in reply to silvestrov]

Silvestrov, Thank you for that. I glanced through the journal article. Eyeballing the plasma concentrations of the 18 patients, I was not at all impressed by the amount of smoothing experienced by the patients treated with psyllium. The only "improvements" that stood out at all were decrease in the no. of multiple peaks, and lower peak concentration. It's not obvious that these modest-looking changes represented "great benefit for patients."

Have you incorporated the psyllium husks in your diet?

[silvestrov in reply to lempa_nik]

I discovered Plantago ovata by asking what herbs are used to treat PD in Indian medicine and discovered the following PDF:

hygeiajournal.com/downloads...

Afterwards I looked for its general uses and noted it was good for constipation. Then I did a search to see if Plantago ovata could be cross referenced with Parkinson's and that is when I found the levodopa + Plantago study.

As the above article states, in Indian science they do investigations about herbs....that are used by the general population for conditions and then develop more refined supplements. So P. ovata may have been used for centuries in India before becoming a standard therapy.

As for myself, I do not use PO because I have been eating raisin brand for decades. I really do not eat a big breakfast but it consists of only 1 bowl of raisin brand. I can remember eating it since (at least) 2005.

[lempa_nik in reply to silvestrov]

Thanks for the interesting article on herbal therapies for brain diseases. One small caution: in Table 3, p. 43, the article wrongly identifies Plantago ovata as "flax seed." Though both may be used to treat constipation, flax seed and psyllium husks (from PO) come from different plants and have different effects:

advancednaturalwellness.net...

livestrong.com/article/3611...

("Plantago ovata" comes from Latin roots meaning "egg-shaped plantain," not "horse flower" as claimed in one internet article!)

[silvestrov in reply to lempa_nik]

I am an artist and flax seed oil is linseed oil. Linseed oil has been used for centuries as a painting medium and I do confess I do not use it when I paint because it yellows with age. Stand oil is non-yellowing and has a lustrous finish.

Either one of two things happened in the article to call psyllium flax. Either it is called flax in India as a nickname or they just botched the article. I saw the same thing you did and wondered about the confusion of terms.

Whatever the Indian scientists called it it is good to know that it has an established use in PD (for decades or perhaps centuries).

[honeycombe3]

Thanks for keeping us up to date.

[gleeson]

I've been intrigued by this report. I was diagnosed with Parkinson's in the fall of 2009. I started a blog back then mainly to report on the success I was having using the over-the-counter serotonin boosting supplement 5-HTP to deal with the insomnia and constipation associated with Parkinson's. I've done a number of posts on the debate I've been having with my doctors and my family and friends and myself over using this supplement. I recently stopped taking it for four months. As soon as I stopped using 5-HTP, I was hit by constipation big time. When not using this supplement, my gut tension feels like the trench warfare in WWI. I've been back on 5-HTP for over a month now and have been pleased with how well the supplement works as a laxative. This study suggests and my experience is in accord that what's going on in the gut has a lot to do with Parkinson's.

For more on this see Http://bit.ly/2aDz05g

[Hidden]

When choosing a laxative, unblock your system gently and naturally. Osmotic laxative works with the water in your body to soften and ease stool through the colon. They are fairly safe to take for long-lasting constipation. Just make sure you drink plenty of water when you take them to avoid getting dehydrated.

Stimulant Laxatives usually have a chemical called senna, which triggers muscles around your intestines to squeeze and move stool through your colon. While they do relieve constipation, you shouldn’t take them on a regular basis. When you take them for a long time, your body can get used to them so that they won’t work for you anymore. You can also get dependent on them, during which you need them to stay regular.

But some people may need more help from bulk-forming laxatives. They add soluble fiber to your stool, which makes it easier to pass by absorbing more water in your intestines. Make sure you drink plenty of water when you take one, though. These laxatives include methylcellulose (Citrucel), polycarbophil (FiberCon), and psyllium (Metamucil).