Study to Evaluate Dietary Modification in Patients With Functional Dyspepsia.

NCT ID: NCT02863822

Last Updated: 2024-10-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2016-09-30

Study Completion Date

2018-06-30

Brief Summary

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The purpose of this study is to evaluate the effectiveness of the low fermentable oligo-di-monosaccharides and polyols (FODMAP) diet in functional dyspepsia (FD). The investigators will compare education in the low FODMAP diet to a standard healthy diet for improving symptoms in FD.

Detailed Description

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Functional Dyspepsia (FD) is defined by the Rome III criteria as bothersome postprandial fullness, early satiation, epigastric pain, or epigastric burning in the absence of structural or systemic disease that can explain the symptoms. These symptoms have been present for at least 3 months with symptom onset 6 months prior to the diagnosis.

The low fermentable oligo-di-monosaccharides and polyols (FODMAP) diet has been studied in irritable bowel syndrome (IBS) patients and has been shown to have modest benefit in a limited number of small studies. The diet is generally started by complete elimination of fructose, lactose, fructans, galactans, and polyols. Following symptom improvement, these groups are reintroduced one at a time while the patient monitors for symptoms.

Although the low FODMAP diet has never been formally studied in patients with functional dyspepsia, we have noted the FD patients report improvement in their symptoms on the diet. This improvement could be explained by reduction in duodenal and gastric distention with the low FODMAP diet or a change in the duodenal flora.

To date, there have been no randomized trials evaluating dietary modification in FD. The purpose of this study is to evaluate the efficacy of the low FODMAP diet in functional dyspepsia. The investigator's hypothesis is that the addition of the FODMAP diet to standard medical treatment will result in improved symptom control in patients with functional dyspepsia.

Conditions

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Dyspepsia Dietary Modification

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Low FODMAP

Subjects will be given dietary education in the low FODMAP diet, which they will continue for 4 weeks. Subjects will then followup with the dietician and subjects with a symptomatic response will be given instructions for reintroduction.

Group Type EXPERIMENTAL

Low FODMAP Diet

Intervention Type BEHAVIORAL

Subjects in the experimental arm, will be educated in the low fermentable oligo-di-monosaccharides and polyols (FODMAP) diet.

Choose My Plate

Subjects will receive dietary counseling in the choose my plate diet as defined by choosemyplate.gov. Subjects will also receive 2 dietician visits, 4 weeks apart.

Group Type ACTIVE_COMPARATOR

Choose My Plate Diet

Intervention Type BEHAVIORAL

Subjects in the active comparator arm will be educated in the ChooseMyPlate.gov Diet.

Interventions

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Low FODMAP Diet

Subjects in the experimental arm, will be educated in the low fermentable oligo-di-monosaccharides and polyols (FODMAP) diet.

Intervention Type BEHAVIORAL

Choose My Plate Diet

Subjects in the active comparator arm will be educated in the ChooseMyPlate.gov Diet.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Men and women 18 years and older
* Diagnosis of FD with either PDS or EPS as measured by Rome III Criteria
* Patients describing inadequate relief of dyspepsia symptoms
* Endoscopy performed in the last 3 years and negative for an organic cause for dyspeptic symptoms
* H pylori negative by non-invasive testing or biopsy. Patients with a history of successfully eradicated H pylori will be included if follow-up testing by stool antigen, urea breath testing, or biopsy is negative
* Celiac disease excluded by serologies or biopsy

Exclusion Criteria

* Patients with IBS predominant symptoms that are not well controlled
* Patients with a diagnosis of GERD who have uncontrolled heartburn
* History of esophagitis, ulcer disease, or other organic upper GI disease, including a diagnosis of celiac disease, gastroparesis, or vascular disorders of the upper GI tract
* History of surgery involving the esophagus, stomach, or duodenum
* Known lactose intolerance, unless symptoms persist on a lactose free diet
* Known fructose intolerance unless symptoms persist on a fructose free diet
* Patients undergoing active titration of any medications
* Pregnant or breastfeeding women
* Prisoners
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wake Forest University Health Sciences

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hina Omar, MD

Role: PRINCIPAL_INVESTIGATOR

Advocate Lutheran General Hospital

Marc Fine, MD

Role: PRINCIPAL_INVESTIGATOR

Advocate Lutheran General Hospital

Locations

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Advocate Lutheran General Hospital

Park Ridge, Illinois, United States

Site Status

Countries

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United States

References

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Staudacher HM, Lomer MC, Anderson JL, Barrett JS, Muir JG, Irving PM, Whelan K. Fermentable carbohydrate restriction reduces luminal bifidobacteria and gastrointestinal symptoms in patients with irritable bowel syndrome. J Nutr. 2012 Aug;142(8):1510-8. doi: 10.3945/jn.112.159285. Epub 2012 Jun 27.

Reference Type BACKGROUND
PMID: 22739368 (View on PubMed)

Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, Smith S, Gibson PR, Muir JG. Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome. J Gastroenterol Hepatol. 2010 Aug;25(8):1366-73. doi: 10.1111/j.1440-1746.2010.06370.x.

Reference Type BACKGROUND
PMID: 20659225 (View on PubMed)

Kerckhoffs AP, Samsom M, van der Rest ME, de Vogel J, Knol J, Ben-Amor K, Akkermans LM. Lower Bifidobacteria counts in both duodenal mucosa-associated and fecal microbiota in irritable bowel syndrome patients. World J Gastroenterol. 2009 Jun 21;15(23):2887-92. doi: 10.3748/wjg.15.2887.

Reference Type BACKGROUND
PMID: 19533811 (View on PubMed)

Talley NJ, Dennis EH, Schettler-Duncan VA, Lacy BE, Olden KW, Crowell MD. Overlapping upper and lower gastrointestinal symptoms in irritable bowel syndrome patients with constipation or diarrhea. Am J Gastroenterol. 2003 Nov;98(11):2454-9. doi: 10.1111/j.1572-0241.2003.07699.x.

Reference Type BACKGROUND
PMID: 14638348 (View on PubMed)

Talley NJ, Van Zanten SV, Saez LR, Dukes G, Perschy T, Heath M, Kleoudis C, Mangel AW. A dose-ranging, placebo-controlled, randomized trial of alosetron in patients with functional dyspepsia. Aliment Pharmacol Ther. 2001 Apr;15(4):525-37. doi: 10.1046/j.1365-2036.2001.00941.x.

Reference Type BACKGROUND
PMID: 11284782 (View on PubMed)

Talley NJ, Locke GR, Saito YA, Almazar AE, Bouras EP, Howden CW, Lacy BE, DiBaise JK, Prather CM, Abraham BP, El-Serag HB, Moayyedi P, Herrick LM, Szarka LA, Camilleri M, Hamilton FA, Schleck CD, Tilkes KE, Zinsmeister AR. Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study. Gastroenterology. 2015 Aug;149(2):340-9.e2. doi: 10.1053/j.gastro.2015.04.020. Epub 2015 Apr 25.

Reference Type BACKGROUND
PMID: 25921377 (View on PubMed)

Talley NJ, Verlinden M, Jones M. Quality of life in functional dyspepsia: responsiveness of the Nepean Dyspepsia Index and development of a new 10-item short form. Aliment Pharmacol Ther. 2001 Feb;15(2):207-16. doi: 10.1046/j.1365-2036.2001.00900.x.

Reference Type BACKGROUND
PMID: 11148439 (View on PubMed)

Other Identifiers

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2015-203

Identifier Type: -

Identifier Source: org_study_id

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