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Exploring the Mechanism of a Probiotic Combination VSL#3 in Irritable Bowel Syndrome

Primary Purpose

Irritable Bowel Syndrome

Status
Completed
Phase
Not Applicable
Locations
Singapore
Study Type
Interventional
Intervention
VSL#3
Placebo
Sponsored by
National University Hospital, Singapore
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Irritable Bowel Syndrome focused on measuring irritable bowel syndrome, rectal hypersensitivity, probiotics, melatonin, brain-gut axis

Eligibility Criteria

18 Years - 68 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Female and male patients with IBS between the ages of 18 and 68 will be recruited. IBS will be diagnosed according to the Rome III diagnostic criteria (Drossman and Dumitrascu, 2006). The history of previous chronic GI symptoms suggestive of IBS should be at least 3 months (not necessarily consecutive) over the preceding 6 months. The stool culture of each subject should be negative for hemoccult, pathogens (Salmonella and Shigella), parasites (Giardia) and ova/ cyst. Only patients who had IBS symptoms for at least one month prior to the study and whose IBS symptom score is of at least a moderate severity on at least one of IBS symptoms will be eligible for inclusion into the study.

Exclusion Criteria:

  • Those subjects who are unwilling or unable to give informed consent, follow protocol or to stop all medications used to treat diarrhoea or colitis
  • Subject taking at the time of proposed enrolment any of the below listed prohibited medications:

    • Anticholinergics (dicyclomine, hyoscyamine, propantheline)
    • Cholinomimetic agents (bethanechol etc.)
    • All narcotics (morphine, codeine, propoxyphene either alone or in any
    • combination)
    • 5-HT3 receptor antagonists (e.g., alosetron, ondansetron, tropisetron, dolasetron, granisetron).
    • Gastrointestinal preparations:
    • Antacids (containing either magnesium or aluminium)
    • Antidiarrheal agents
    • Bismuth compounds
    • Laxatives (stimulant or osmotic)
    • Sulfasalazine
  • Treatment with immunosuppressive medications or presence of an immunocompromised state
  • If currently using medication (like those used in Diabetes mellitus, Sarcoidosis, Connective tissue disease, poorly controlled hypo/hyperthyroidism) may alter bowel motility or if under long term antibiotic therapy
  • Use of any other investigational drug and/or participation in any clinical trial within 3 months of entry to this study
  • Patients will be excluded if they had undergone previous abdominal surgery (except appendectomy, Caesarean section, Cholecystectomy, Tubal ligation, Hysterectomy, Hernia repair ≥ 6 months prior to enrolment)
  • Subject who has been diagnosed with any of the following GI disorders:

    • Inflammatory bowel disease (Crohn's disease, Ulcerative colitis, Indeterminate Colitis
    • Microscopic colitis (lymphocytic colitis, collagenous colitis)
    • Celiac Disease
    • Gastroparesis
    • Gastrointestinal obstruction and/or stricture
    • Chronic pancreatitis
  • Subject with a significant concomitant psychiatric, neurological, metabolic, renal, hepatic, infections, hematological, C.V or pulmonary illness, unless condition is stable and judged by the investigator that such condition does not interfere with the patients participation in the study.

Sites / Locations

  • National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

VSL#3

Placebo

Arm Description

Patients taking probiotics (VSL#3)

Identical looking preparation of placebo taken at the same dose regimen as the active comparator

Outcomes

Primary Outcome Measures

Resolution of symptoms

Secondary Outcome Measures

Rectal sensitivity
Saliva and fecal melatonin levels

Full Information

First Posted
November 4, 2008
Last Updated
March 2, 2011
Sponsor
National University Hospital, Singapore
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1. Study Identification

Unique Protocol Identification Number
NCT00786123
Brief Title
Exploring the Mechanism of a Probiotic Combination VSL#3 in Irritable Bowel Syndrome
Official Title
Exploring the Mechanism of a Probiotic Combination VSL#3 in Irritable Bowel Syndrome: a Randomized Double Blind Placebo Controlled Study
Study Type
Interventional

2. Study Status

Record Verification Date
March 2011
Overall Recruitment Status
Completed
Study Start Date
May 2006 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
National University Hospital, Singapore

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Irritable bowel syndrome (IBS) is a very common chronic gastrointestinal disorder. Existing therapies for IBS are still far from satisfactory and new therapies are being constantly sought. Probiotics are promising candidate for the prevention and treatment of IBS. However, its efficacy and mechanism is still unclear. The current study aims to evaluate the effects of a combination probiotic, VSL#3, on symptoms and rectal sensitivity in patients with IBS. The underlying mechanism will also be investigated. We will recruit forty patients with Rome III IBS and randomized them, in a parallel group, double-blinded design, to take four VSL#3 capsules or placebos, twice daily, for six weeks. Before and after treatment, patients will be assessed for their symptoms, rectal sensitivity, as well as saliva and fecal melatonin levels. Bowel symptom diary and weekly satisfactory relief of bowel symptoms will also be recorded and evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Irritable Bowel Syndrome
Keywords
irritable bowel syndrome, rectal hypersensitivity, probiotics, melatonin, brain-gut axis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
VSL#3
Arm Type
Experimental
Arm Description
Patients taking probiotics (VSL#3)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Identical looking preparation of placebo taken at the same dose regimen as the active comparator
Intervention Type
Dietary Supplement
Intervention Name(s)
VSL#3
Other Intervention Name(s)
probiotics
Intervention Description
Dose: 4 capsules of VSL#3 daily for 6 weeks.
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Identical looking preparation of placebo taken at the same dose regimen as the active comparator
Primary Outcome Measure Information:
Title
Resolution of symptoms
Time Frame
6 weeks
Secondary Outcome Measure Information:
Title
Rectal sensitivity
Time Frame
6 weeks
Title
Saliva and fecal melatonin levels
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
68 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female and male patients with IBS between the ages of 18 and 68 will be recruited. IBS will be diagnosed according to the Rome III diagnostic criteria (Drossman and Dumitrascu, 2006). The history of previous chronic GI symptoms suggestive of IBS should be at least 3 months (not necessarily consecutive) over the preceding 6 months. The stool culture of each subject should be negative for hemoccult, pathogens (Salmonella and Shigella), parasites (Giardia) and ova/ cyst. Only patients who had IBS symptoms for at least one month prior to the study and whose IBS symptom score is of at least a moderate severity on at least one of IBS symptoms will be eligible for inclusion into the study. Exclusion Criteria: Those subjects who are unwilling or unable to give informed consent, follow protocol or to stop all medications used to treat diarrhoea or colitis Subject taking at the time of proposed enrolment any of the below listed prohibited medications: Anticholinergics (dicyclomine, hyoscyamine, propantheline) Cholinomimetic agents (bethanechol etc.) All narcotics (morphine, codeine, propoxyphene either alone or in any combination) 5-HT3 receptor antagonists (e.g., alosetron, ondansetron, tropisetron, dolasetron, granisetron). Gastrointestinal preparations: Antacids (containing either magnesium or aluminium) Antidiarrheal agents Bismuth compounds Laxatives (stimulant or osmotic) Sulfasalazine Treatment with immunosuppressive medications or presence of an immunocompromised state If currently using medication (like those used in Diabetes mellitus, Sarcoidosis, Connective tissue disease, poorly controlled hypo/hyperthyroidism) may alter bowel motility or if under long term antibiotic therapy Use of any other investigational drug and/or participation in any clinical trial within 3 months of entry to this study Patients will be excluded if they had undergone previous abdominal surgery (except appendectomy, Caesarean section, Cholecystectomy, Tubal ligation, Hysterectomy, Hernia repair ≥ 6 months prior to enrolment) Subject who has been diagnosed with any of the following GI disorders: Inflammatory bowel disease (Crohn's disease, Ulcerative colitis, Indeterminate Colitis Microscopic colitis (lymphocytic colitis, collagenous colitis) Celiac Disease Gastroparesis Gastrointestinal obstruction and/or stricture Chronic pancreatitis Subject with a significant concomitant psychiatric, neurological, metabolic, renal, hepatic, infections, hematological, C.V or pulmonary illness, unless condition is stable and judged by the investigator that such condition does not interfere with the patients participation in the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ho Khek Yu
Organizational Affiliation
National University Hospital, Singapore
Official's Role
Principal Investigator
Facility Information:
Facility Name
National University Hospital
City
Singapore
ZIP/Postal Code
119074
Country
Singapore

12. IPD Sharing Statement

Citations:
PubMed Identifier
17259088
Citation
Camilleri M. Is there a role for probiotics in irritable bowel syndrome? Dig Liver Dis. 2006 Dec;38 Suppl 2:S266-9. doi: 10.1016/S1590-8658(07)60007-3.
Results Reference
background
PubMed Identifier
16197493
Citation
Shen B, Brzezinski A, Fazio VW, Remzi FH, Achkar JP, Bennett AE, Sherman K, Lashner BA. Maintenance therapy with a probiotic in antibiotic-dependent pouchitis: experience in clinical practice. Aliment Pharmacol Ther. 2005 Oct 15;22(8):721-8. doi: 10.1111/j.1365-2036.2005.02642.x.
Results Reference
background
PubMed Identifier
16846694
Citation
Song GH, Venkatraman V, Ho KY, Chee MW, Yeoh KG, Wilder-Smith CH. Cortical effects of anticipation and endogenous modulation of visceral pain assessed by functional brain MRI in irritable bowel syndrome patients and healthy controls. Pain. 2006 Dec 15;126(1-3):79-90. doi: 10.1016/j.pain.2006.06.017. Epub 2006 Jul 18.
Results Reference
background
PubMed Identifier
15914575
Citation
Song GH, Leng PH, Gwee KA, Moochhala SM, Ho KY. Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: a randomised, double blind, placebo controlled study. Gut. 2005 Oct;54(10):1402-7. doi: 10.1136/gut.2004.062034. Epub 2005 May 24.
Results Reference
background

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Exploring the Mechanism of a Probiotic Combination VSL#3 in Irritable Bowel Syndrome

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