By: Grace Huff
At the Norman Fixel Institute for Neurological Diseases at UF Health, a groundbreaking care model is transforming how Parkinson’s disease (PD) is treated, by starting in the gut.
While tremors, stiffness, and slowed movement are the most recognizable symptoms of Parkinson’s disease, many patients quietly struggle with something equally disruptive: gastrointestinal (GI) issues. Constipation, bloating, nausea, and swallowing difficulties not only reduce quality of life but also interfere with medication absorption and nutrition. Despite these consequences, GI symptoms have long remained in the background of PD care, underdiagnosed, undertreated, and poorly understood.
The PRISM Clinic, launched by the Fixel Institute, is setting out to change that narrative. PRISM, short for Proactive, Integrated, and Specialized Multidisciplinary care, is the first interdisciplinary clinic of its kind designed specifically to treat GI symptoms in people with Parkinson’s. This new model offers a comprehensive, team-based approach that brings multiple specialists together in a single coordinated visit to deliver care that is not only more effective but also easier for patients to navigate. “The most compelling aspect of the PRISM model is its holistic, patient-centered approach,” said author Grace Hey. “We’re not just treating symptoms, we’re treating people, and we’re doing it together.”
Historically, GI symptoms in Parkinson’s have been overlooked due to a strong focus on motor symptoms such as tremor, rigidity, bradykinesia, and postural instability. This motor-centric model left non-motor symptoms, like GI dysfunction, to be treated reactively, often after they became severe.
“The need for a multidisciplinary, proactive care model became clear,” said Hey, “GI symptoms are complex, often chronic, and multifactorial. Treating them in isolation is ineffective. They must be addressed as part of the larger Parkinson’s picture.” Recognizing this, the Fixel Institute developed PRISM to integrate care across disciplines. The clinic includes movement disorder neurologists, neurogastroenterologists, dietitians, speech and swallow therapists, pelvic floor health therapists, and researchers, working collaboratively to provide a unified treatment strategy.
“The PRISM model’s integrated team structure facilitates seamless communication and collaboration among various specialists, enabling a comprehensive assessment of the patient’s condition,” said Hey. This collaborative care model enables PRISM to identify overlapping symptoms, minimize gaps in treatment, and reduce the stress patients often experience from juggling separate medical appointments.
Emerging research suggests that GI dysfunction can occur years, even decades, before the onset of motor symptoms in PD. Issues such as dysphagia, delayed gastric emptying, and constipation may not only complicate daily living but also serve as early indicators of the disease.
“A comprehensive evaluation of the entire GI tract allows for the identification of the full spectrum of GI dysfunctions, facilitating more effective and targeted interventions,” Hey said. PRISM’s integrated team takes a “full-tract” approach, assessing GI function from top to bottom. This includes screening for gastroparesis, small intestinal bacterial overgrowth (SIBO), and pelvic floor dysfunction, along with in-depth dietary assessments and swallowing evaluations.
The PRISM Clinic also supports a robust research program focused on the gut microbiome and its role in Parkinson’s. Researchers at the Fixel Institute are investigating how shifts in gut bacteria over time may contribute to PD progression, and how these changes might one day be used to predict disease onset or serve as targets for novel therapies.
“Science is showing us that the gut may be the beginning of Parkinson’s journey,” she explained, “If we can understand what’s happening there, we might be able to improve care and even slow progression.”
With PRISM, the Fixel Institute is setting a new standard in Parkinson’s care, one that recognizes the importance of non-motor symptoms and the power of teamwork. As the clinic grows, it hopes to serve as a blueprint for other institutions looking to adopt integrated care models that are as innovative as they are compassionate.
By reimagining care from the inside out, PRISM offers hope, not just for better management of symptoms, but for a fundamentally better experience of life with Parkinson’s. Click here to learn more.