H. pylori and Parkinson's Disease
Helicobacter Pylori (H.
pylori) is a bacterium often present in upper GI tract in gastric ulcers. This
bacterium has been shown to compromise levodopa absorption in the gut, thus
limiting its effect. Levodopa with carbidopa (Sinemet) is often a drug of
choice for patients with PD and for good reasons.
Sinemet is a dopamine
agonist and helps many patients with PD improve mobility, minimize bradi and
akinesia. Many patients rely on it heavily for daily functional mobility; thus
if the action of this medication is compromised by patient’s enteral system due
presence of H. pylori, then the symptoms of PD prevail.
So how prevalent is
H.pylori infection in patients with PD? According to Hashim, H. et al, they
found 32.9% of their study sample tested positive for H. pylori. Using C-urea
breath test (UBT) is a non-invasive and not expensive way to test for presence
of H. pylori in the gut. Eradication of this bacterium is also somewhat simple.
Usually, the doctor prescribes the “triple therapies,” which includes one
proton pump inhibitor and two antibiotics.
Hashim’s study revealed
findings at six and 12 weeks to be very positive. Patients who tested positive
for H. pylori via UBT and undergone standard tripe therapy eradication improved
their mobility, motivation, ADLs, gait, “ON” time and overall quality of life
as noted in standardized tests such as PDQ-39, UPDRS and others.
between H. pylori and Parkinson’s disease (PD) is increasingly recognized, still very few
patients actually undergo testing and its eradication. As therapists, we should
be aware of this finding and advocate for our patients.
1) Hashim, H., Azmin, S.,
Razlan H., et al. Eradication of helicobacter pylori infection improves
Levodopa Action, clinical symptoms, and quality of life in Patients with
Parkinson’s Disease. PLosONE9 (11) 2014.