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.

Though association 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.

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About Author

Viktoriya Friedman
Viktoriya Friedman

Viktoriya Friedman is a board certified clinical exercise expert on exercise for aging adults (CEEAA). Her primary clinical interest has been working with adult and geriatric patients living with diagnoses of idiopathic PD, atypical PD, ataxia and MS. In this capacity, Viktoriya developed the first skilled nursing facility (SNF)-based telemedicine program for Parkinson’s (PD) and other movement disorders. She started a community-based outreach program to promote exercise for patients with movement disorders: ParkFIT. As an LSVT BIG certified clinician she evaluates and provides specialized treatment for patients with idiopathic PD and PD-like disorders. Currently working at Office of Mental Health (OMH), Viktoriya is treating patients with medication/drug-induced gait and balance disorders. As a Director of Rehabilitation Services for nine years prior, she focused on value based outcome services, ethical clinical decision making, program and staff development, as well as specialized program development to improve quality of rehabilitation care provided. Viktoriya graduated from Boston University Sargent College in 2003 and is currently pursuing her DPT at Arcadia University.

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