Effects of Dietary Fibre in Irritable Bowel Syndrome (IBS)

NCT ID: NCT03803319

Last Updated: 2020-02-06

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

COMPLETED

Clinical Phase

NA

Total Enrollment

135 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-02

Study Completion Date

2020-01-11

Brief Summary

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The aim of the study is to investigate how different dietary fibre combinations affects physiological and microbiological outcomes, in addition to symptoms in those with IBS. The study will also explore the differences in responses between different fibres in different sub-types of IBS (e.g. constipation-predominant, diarrhoea-predominant and mixed).

Detailed Description

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Currently, national and international guidelines are based upon trials of dietary fibre in IBS symptoms that report opposing effects. For this reason, recommendations regarding dietary fibre food supplementation in IBS are often conflicting. Indeed, the confusion surrounding dietary fibre recommendations in IBS is a consequence of the limited understanding of the different types of dietary fibres used, their physiology and their functions in different sub-groups of IBS.

Different fibres have different characteristics (e.g. solubility, viscosity and fermentability) which drive different functionalities (stool forming, fermentation) in the gastrointestinal tract, yet it is currently unknown whether administration of dietary fibre combinations will result in symptomatic improvement in people with IBS.

Participants will be randomised to one of three parallel arms for a duration of 8 weeks.

The study will consist of 4 visits in total. The first visit will involve taking consent and assessing eligibility. Participants will complete the Rome IV diagnostic criteria as part of their eligibility assessment. Participants will be asked to complete a food and symptom diary for the next 7 days. Diary data will be used to confirm frequency and severity of IBS symptoms and ensure there is no discrepancy between participant report on the Rome IV diagnostic criteria.

Visit 2: Baseline (approx 1.5 hours). Height and weight will be recorded. Participants will complete 7 questionnaires, provide a stool sample, a blood sample and will ingest the SmartPill (wireless motility capsule). Participants will blinded to the intervention and will be provided with sachets containing either fibre 1 (combined fibres), fibre 2 (natural fibres) or placebo to consume over an 8-week period.

Visit 3: Mid-point (approx 1 hour). Participants will complete 5 questionnaires and provide a stool sample.

Visit 4: Endpoint (approx 1.5 hours). Height and weight will be recorded. Participants will complete 7 questionnaires, provide a stool sample, a blood sample and will ingest the SmartPill (wireless motility capsule).

Conditions

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Irritable Bowel Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

multi-centre, 3 treatment, placebo-controlled trial
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
Participants and Investigators will be blinded to the fibre provided over the 8-week intervention period.

Study Groups

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Fibre 1 (combined fibres)

Ingestion of 150mls water with 7.5g fibre (two times a day)

Group Type ACTIVE_COMPARATOR

Fibre 1 (combined fibres)

Intervention Type DIETARY_SUPPLEMENT

Dietary fibre supplement

Fibre 2 (natural fibres)

Ingestion of 150mls water with 15g fibre (two times a day)

Group Type ACTIVE_COMPARATOR

Fibre 2 (natural fibres)

Intervention Type DIETARY_SUPPLEMENT

Dietary fibre supplement

Dietary Supplement (placebo)

Ingestion of 150mls water with 7.5g (two times a day)

Group Type PLACEBO_COMPARATOR

Dietary Supplement: placebo

Intervention Type DIETARY_SUPPLEMENT

Dietary supplement

Interventions

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Fibre 1 (combined fibres)

Dietary fibre supplement

Intervention Type DIETARY_SUPPLEMENT

Fibre 2 (natural fibres)

Dietary fibre supplement

Intervention Type DIETARY_SUPPLEMENT

Dietary Supplement: placebo

Dietary supplement

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Interested in taking part
* Ability to give informed consent
* Men and women aged 18-65 years with diarrhoea-predominant IBS (IBS-D), constipation-dominant IBS (IBS-C), or mixed (IBS-M), based on fulfilment of the Rome IV criteria for irritable bowel syndrome who do not have a major medical condition (e.g. diabetes, psychiatric or current eating disorders), severe oesophagitis, gastritis or duodenitis, gastrointestinal disease (inflammatory bowel disease, coeliac disease, active diverticulitis), or history of previous GI surgery (excluding appendicectomy, cholecystectomy and haemorrhoidectomy), severe renal, cardiac, pulmonary, or other chronic diseases likely to affect motility, history of gastric bezoars.

Exclusion Criteria

* Females who report to be pregnant or lactating
* Body Mass Index (BMI) \>40 kg/m2
* Use of unpermitted medications in the last 4 weeks prior to, or during the study including: Antibiotics within the last 4weeks, dietary fibre food supplements within the last 4 weeks (e.g. Fybogel, Lactulose), prebiotics or probiotics (in food products or as supplements) within the last 4 weeks, other dietary supplements that may affect the luminal microenvironment of the intestine (e.g. Orlistat)
* Use of drugs known to alter GI motility, transit or gastric pH (e.g. mebeverine, opiates, monoamine oxidase inhibitors, phenothiazines) in the last 1 week
* Full bowel preparation for a diagnostic procedure within the last 4 weeks
* Changes to IBS medications or dose in the 4 weeks prior to the study
* Changes to anti-depressant medications or dose in the 12 weeks prior to the study
* Swallowing disorders (physical or psychological)
* Use of implantable and/or medical devices such as pacemakers
* Individuals following extreme diets e.g. 8 or more caffeinated serves per day, 4 or more bottles of wine (40 or more units of alcohol per week) or equivalent per week as assessed by diet questionnaires or changes to smoking habits
* Individuals who have participated in other intervention trials within 3 months prior to screening
* Allergies to components (soy) of the SmartBar (required for SmartPill protocol)
* Abdominal pain for less than 2 days in the screening week (based on the GSRS mild to severe)
* Those who report adequate relief of symptoms at baseline using the GSQ
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Guy's and St Thomas' NHS Foundation Trust

OTHER

Sponsor Role collaborator

Universidad Veracruzana

OTHER

Sponsor Role collaborator

University of Liverpool

OTHER

Sponsor Role collaborator

King's College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kevin C Whelan, PhD

Role: STUDY_DIRECTOR

King's College London

Locations

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King's College London

London, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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18/WA/0313

Identifier Type: -

Identifier Source: org_study_id

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