Trial Outcomes & Findings for A Longitudinal Study to Identify IBS Phenotypes Using Fecal Microbiota and Hydrogen Breath Testing (NCT NCT03219528)

NCT ID: NCT03219528

Last Updated: 2025-04-27

Results Overview

Change in mean daily abdominal pain was measured using a visual analog scale (VAS) after intervention compared with baseline. VAS was a scale of 0 to 10, with higher numbers indicating a higher degree of pain; 0 indicated no pain and 10 indicated severe pain.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

74 participants

Primary outcome timeframe

Baseline, Week 5

Results posted on

2025-04-27

Participant Flow

Participant milestones

Participant milestones
Measure
Rifaximin
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Overall Study
STARTED
38
36
Overall Study
Actual Treatment Begun
36
29
Overall Study
COMPLETED
29
28
Overall Study
NOT COMPLETED
9
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Rifaximin
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Overall Study
Lost to Follow-up
5
4
Overall Study
Withdrawal by Subject
4
4

Baseline Characteristics

A Longitudinal Study to Identify IBS Phenotypes Using Fecal Microbiota and Hydrogen Breath Testing

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Rifaximin
n=38 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=36 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Total
n=74 Participants
Total of all reporting groups
Age, Continuous
44.2 years
STANDARD_DEVIATION 17.9 • n=5 Participants
44.1 years
STANDARD_DEVIATION 16.4 • n=7 Participants
44.1 years
STANDARD_DEVIATION 17.0 • n=5 Participants
Sex: Female, Male
Female
30 Participants
n=5 Participants
26 Participants
n=7 Participants
56 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
10 Participants
n=7 Participants
18 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
35 Participants
n=5 Participants
34 Participants
n=7 Participants
69 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
White
34 Participants
n=5 Participants
33 Participants
n=7 Participants
67 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
38 Participants
n=5 Participants
36 Participants
n=7 Participants
74 Participants
n=5 Participants
Body Mass Index (BMI)
29.7 kg/m^2
STANDARD_DEVIATION 8.72 • n=5 Participants
29.8 kg/m^2
STANDARD_DEVIATION 8.18 • n=7 Participants
29.8 kg/m^2
STANDARD_DEVIATION 8.41 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a modified intent to treat (mITT) analysis.

Change in mean daily abdominal pain was measured using a visual analog scale (VAS) after intervention compared with baseline. VAS was a scale of 0 to 10, with higher numbers indicating a higher degree of pain; 0 indicated no pain and 10 indicated severe pain.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Mean Daily Abdominal Pain
Baseline
5.2 score on a scale
Standard Deviation 1.8
5.3 score on a scale
Standard Deviation 1.6
Change in Mean Daily Abdominal Pain
Week 5
3.9 score on a scale
Standard Deviation 2.5
3.8 score on a scale
Standard Deviation 2.0

PRIMARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

Change in mean daily bloating was measured using a visual analog scale (VAS) after intervention compared with baseline. VAS was a scale of 0 to 10, with higher numbers indicating a higher degree of bloating; 0 indicated no bloating and 10 indicated severe bloating.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Mean Daily Bloating
Baseline
4.9 score on a scale
Standard Deviation 1.9
5.1 score on a scale
Standard Deviation 2.2
Change in Mean Daily Bloating
Week 5
4.0 score on a scale
Standard Deviation 2.4
3.7 score on a scale
Standard Deviation 2.1

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

The IBS Symptom Severity Scale was comprised of 5 questions each of which was on a scale of 0 to 100, with higher scores indicating more severe symptoms. The total range of the scale was 0 to 500, with 0 meaning no IBS symptoms and 500 indicating severe IBS symptoms.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Irritable Bowel Syndrome (IBS) Symptom Severity Scale
Baseline
281.3 score on a scale
Standard Deviation 81.0
272.0 score on a scale
Standard Deviation 65.1
Change in Irritable Bowel Syndrome (IBS) Symptom Severity Scale
Week 5
209.3 score on a scale
Standard Deviation 81.8
194.7 score on a scale
Standard Deviation 79.1

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

The GSRS was a disease-specific instrument of 15 items combined into five symptom clusters depicting Reflux, Abdominal Pain, Indigestion, Diarrhea, and Constipation. The GSRS had a seven-point graded Likert scale where 1 represents absence of troublesome symptoms and 7 represents very troublesome symptoms. The total range of the scale is 15 to 105 with 15 meaning low symptom burden and 105 meaning high symptom burden.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Gastrointestinal System Ratings Scale (GSRS)
Baseline
52.0 score on a scale
Standard Deviation 13.2
52.1 score on a scale
Standard Deviation 13.3
Change in Gastrointestinal System Ratings Scale (GSRS)
Week 5
40.7 score on a scale
Standard Deviation 11.0
40.1 score on a scale
Standard Deviation 12.2

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

The Bristol Stool Form Scale was a diagnostic tool used to assess various digestive issues based on the type and shape of stool. The total range of the scale was 1 to 7, with 1 indicating hard stool and 7 indicating liquid stool.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Stool Form
Baseline
5.6 score on a scale
Standard Deviation 0.8
5.6 score on a scale
Standard Deviation 0.8
Change in Stool Form
Week 5
5.0 score on a scale
Standard Deviation 1.1
5.3 score on a scale
Standard Deviation 0.9

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

The PHQ-9 was a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression. It is comprised of 9 questions, each ranging from 0 to 3 with higher values indicating more severe depression symptoms. The total range of the scale was 1 to 27, with 1 indicating no or minimal depression and 27 indicating severe depression.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Psychological Function
Baseline
8.6 score on a scale
Standard Deviation 6.5
8.3 score on a scale
Standard Deviation 6.2
Change in Psychological Function
Week 5
6.2 score on a scale
Standard Deviation 4.9
5.8 score on a scale
Standard Deviation 4.3

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

IBS-QOL was a condition-specific instrument for assessing health-related quality of life among persons with IBS. The IBS-QOL was comprised of 34 questions, each with a 5-point scale where the higher the value indicated the higher quality of life. The total range of the scale was 0 to 100, with 0 indicating no quality of life and 100 indicating extremely good quality of life.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
Change in Irritable Bowel Syndrome Quality of Life Instrument (IBS-QOL)
Baseline
53.6 score on a scale
Standard Deviation 19.5
58.9 score on a scale
Standard Deviation 21.5
Change in Irritable Bowel Syndrome Quality of Life Instrument (IBS-QOL)
Week 5
62.6 score on a scale
Standard Deviation 20.4
67.8 score on a scale
Standard Deviation 18.5

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

Participants completed entries using the Nutrition Data System for Research (NDSR), which was a Windows-based dietary analysis program designed for the collection and analyses of 24-hour dietary recalls, food records, menus, and recipes. The NDSR was incapable of collecting data on all FODMAP-type foods, aside from lactose and gluten. The results represent data from lactose as a surrogate for all other FODMAP foods.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
24-hour Diet Recall/Intake - Lactose
Baseline
4.1 grams per day
Standard Deviation 5.5
7.3 grams per day
Standard Deviation 9.6
24-hour Diet Recall/Intake - Lactose
Week 5
5.1 grams per day
Standard Deviation 6.7
1.4 grams per day
Standard Deviation 2.3

SECONDARY outcome

Timeframe: Baseline, Week 5

Population: Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed at each time point is based on a mITT analysis.

Participants completed entries using the Nutrition Data System for Research (NDSR), which was a Windows-based dietary analysis program designed for the collection and analyses of 24-hour dietary recalls, food records, menus, and recipes. The NDSR was incapable of collecting data on all FODMAP-type foods, aside from lactose and gluten. The results represent data from gluten as a surrogate for all other FODMAP foods.

Outcome measures

Outcome measures
Measure
Rifaximin
n=36 Participants
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 Participants
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
24-hour Diet Recall/Intake - Gluten
Baseline
6.7 grams per day
Standard Deviation 6.0
5.7 grams per day
Standard Deviation 5.6
24-hour Diet Recall/Intake - Gluten
Week 5
7.2 grams per day
Standard Deviation 6.5
1.7 grams per day
Standard Deviation 4.2

OTHER_PRE_SPECIFIED outcome

Timeframe: 4 weeks

Glucose breath tests (GBT) will be performed at baseline and repeated after intervention

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: 4 weeks

Changes in fecal microbial diversity after intervention will be compared with baseline.

Outcome measures

Outcome data not reported

Adverse Events

Rifaximin

Serious events: 0 serious events
Other events: 30 other events
Deaths: 0 deaths

Low FODMAP Group

Serious events: 0 serious events
Other events: 26 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Rifaximin
n=36 participants at risk
Rifaximin 550 mg three times daily for 14 days Rifaximin 550 MG: Rifaximin 550 mg three times daily for 14 days
Low FODMAP Group
n=29 participants at risk
Low FODMAP diet for 4 weeks Low FODMAP Diet: Low FODMAP dietary intervention for 4 weeks
General disorders
Dizziness/Light-headedness
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Abdominal Pain and cramping
13.9%
5/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
27.6%
8/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Bloating and gas
8.3%
3/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
27.6%
8/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Heartburn
16.7%
6/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
3.4%
1/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Nausea
13.9%
5/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
6.9%
2/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Diarrhea
0.00%
0/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
17.2%
5/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Constipation
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
6.9%
2/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
General disorders
Headache
5.6%
2/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Belching
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Renal and urinary disorders
Increased urination
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Skin and subcutaneous tissue disorders
Easily sunburned
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
General disorders
Fatigue
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
General disorders
Swelling
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Eye disorders
Blurry Vision
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
Gastrointestinal disorders
Mucus in Stool
2.8%
1/36 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.
0.00%
0/29 • 5 weeks
Some participants who were randomized to an arm withdrew or were lost to follow up before receiving an intervention. The number of participants analyzed is based on a mITT analysis.

Additional Information

Allen Lee

University of Michigan

Phone: 734-936-4785

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place