Effect of Chronic Feeding of Inulin And Methylcellulose on Colonic Fermentation

NCT ID: NCT06551961

Last Updated: 2024-11-15

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

RECRUITING

Clinical Phase

NA

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-30

Study Completion Date

2025-06-30

Brief Summary

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To determine the effect on tolerance and gas production from chronic feeding of fermentable fibre (inulin) incorporated into a gel forming fibre (methylcellulose) compared with placebo (maltodextrin)

Detailed Description

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Our challenge is to understand how various dietary fibres interact to alter colonic fermentation of FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) with the aim of reducing gaseous distension of the colon and hence symptoms. Our previous studies have shown how psyllium, a gel forming natural fibre can reduce gas production induced by a dietary FODMAP inulin when it reaches the colon. The investigators are exploiting a range of food grade modified celluloses which can form gels at body temperature to perform human studies to explore whether the beneficial effect of psyllium is unique or will be found with all gelling substances 2.

The investigators have completed a study using a modified methylcellulose which was shown to be non-inferior to psyllium.

Our previous studies point to the importance of habitual FODMAP intake which is likely to alter the microbiota, selecting those that can efficiently utilise fructans. The investigators want to understand whether chronic feeding of inulin along with methylcellulose, a gel-forming dietary fibre which persists in the colon, will significantly alter the tolerance to inulin relative to chronic feeding of inulin with a suitable placebo maltodextrin. Maltodextrin is rapidly absorbed in the small bowel and therefore has no effect on colonic fermentation. The investigators plan to run a chronic feeding study in IBS patients and wish to ascertain tolerability of repeated use as previous studies have only provided single doses.

With this in mind, the investigators plan to provide inulin and methylcellulose for daily consumption by healthy adults for a period of two weeks. The intervention will be divided into 3 portions to be taken before breakfast, lunch and supper. In week 1, the portions will contain 2.5 g of both inulin and methylcellulose in 62.5 mL water. In week 2, the portions will contain 5.0 g of both inulin and methylcellulose in 125 mL water. The participants will also follow the same chronic feeding schedule but with a maltodextrin placebo as opposed to methylcellulose, with randomisation of study schedule taking place at screening.

The investigators will use MRI at baseline and at 2 weeks to assess changes in colonic volume and transit utilising high MRI contrast capsules54. The investigators will collect stool samples at baseline and after 1 and 2 weeks of chronic feeding for each study intervention to monitor the expected changes in microbiota. The primary objective is to assess the fermentation of inulin given as a single 15g with or without methylcellulose from the breath hydrogen response at baseline and after the 2 weeks feeding. .

Conditions

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Irritable Bowel Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

2 treatment two period cross-over trial
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Servings provided in identical pots whose content is only known by one assistant who is not involved in collecting outcomes or analysis of results

Study Groups

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methylcellulose

2.5 g of Inulin and 2.5g methylcellulose in 62.5 mL water given thrice daily for 7 days increasing to 5 g of Inulin and 5g methylcellulose in 125 mL water on day 8 continuing until day 14

Group Type ACTIVE_COMPARATOR

methylcellulose

Intervention Type DIETARY_SUPPLEMENT

2.5 and 5 gm Methylcelllose heated to create a gel

inulin

Intervention Type DIETARY_SUPPLEMENT

2.5 and 5 gm inulin powder dissolved in water

Placebo

2.5 g of Inulin and 2.5g maltodextrin in 62.5 mL water given thrice daily for 7 days increasing to 5 g of Inulin and 5g maltodextrin in 125 mL water on day 8 continuing until day 14

Group Type PLACEBO_COMPARATOR

inulin

Intervention Type DIETARY_SUPPLEMENT

2.5 and 5 gm inulin powder dissolved in water

maltodextrin

Intervention Type DIETARY_SUPPLEMENT

2.5 and 5gm maltodextrin dissolved in water

Interventions

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methylcellulose

2.5 and 5 gm Methylcelllose heated to create a gel

Intervention Type DIETARY_SUPPLEMENT

inulin

2.5 and 5 gm inulin powder dissolved in water

Intervention Type DIETARY_SUPPLEMENT

maltodextrin

2.5 and 5gm maltodextrin dissolved in water

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Benecel Glusidex

Eligibility Criteria

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Inclusion Criteria

* • Aged between 18 and 65 years old.

* Able to give informed consent.
* Scoring ≤5 (i.e., mild, or less) for symptoms of flatulence, bloating, abdominal pain, loose stool, and hard stool in previous 2 weeks using a modified Gastrointestinal Symptom Rating Scale (5).
* Agrees to consume the meals provided.
* Agrees to not smoke during the breath hydrogen sampling period.

Exclusion Criteria

* • Pregnancy, lactating, or planning pregnancy during the course of the investigation declared by candidate.

* History declared by the candidate of pre-existing gastrointestinal disorder that may affect bowel function.
* Reported history of previous resection of the oesophagus, stomach, or intestine (excluding appendix).
* Intestinal stoma.
* Any medical condition making participation potentially compromising participation in the study e.g., diabetes mellitus, respiratory disease limiting ability to use breath hydrogen analyser, known intolerance to one of the test substances.
* Has a body mass index (BMI) value less than 18.5 or greater than 35.
* Will not agree to follow dietary and lifestyle restrictions required.
* Participants who are taking antibiotics or probiotics as it might alters gut microbiota.
* Poor understanding of English language.
* Participation in night shift work the week prior to the study day. Night work is defined as working between midnight and 6.00 AM.
* Anyone who in the opinion of the investigator is unlikely to be able to comply with the protocol e.g., cognitive dysfunction, chaotic lifestyle related to substance abuse.
* Having taken part in a research study in the last 3 months involving invasive procedures or an inconvenience allowance.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of East Anglia

OTHER

Sponsor Role collaborator

University of Nottingham

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Robin C Spiller, MD

Role: PRINCIPAL_INVESTIGATOR

University of Nottingham

Locations

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Nottingham Digestive Disease Centre

Nottingham, Nottinghamshire, United Kingdom

Site Status RECRUITING

Nottingham Digestive Diseases Centre

Nottingham, Please Choose..., United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Alsion Thorpe, MD

Role: CONTACT

+44 (0)115 7486731

Sponsor

Role: CONTACT

+44 (0)115 7486731

Facility Contacts

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Alaa Alhasani, BSc

Role: primary

01159429924

Abi Spicer, PhD

Role: primary

Joshua Reid, PhD

Role: backup

References

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Gunn D, Abbas Z, Harris HC, Major G, Hoad C, Gowland P, Marciani L, Gill SK, Warren FJ, Rossi M, Remes-Troche JM, Whelan K, Spiller RC. Psyllium reduces inulin-induced colonic gas production in IBS: MRI and in vitro fermentation studies. Gut. 2022 May;71(5):919-927. doi: 10.1136/gutjnl-2021-324784. Epub 2021 Aug 5.

Reference Type RESULT
PMID: 34353864 (View on PubMed)

Other Identifiers

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FMHS-199-0524

Identifier Type: -

Identifier Source: org_study_id

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