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Fibers and Gut Health

Primary Purpose

Constipation

Status
Completed
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
High quantity fiber
Low quantity fiber
Placebo
Sponsored by
Société des Produits Nestlé (SPN)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Constipation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Men or women aged 18-75; female subjects of child-bearing potential must be willing to use a reliable method of contraception throughout the study period
  • BMI: 18.5 - 29.9 kg/m2
  • Recruitment based on simplified core ROME III diagnostic criteria for functional constipation (based on specific screening questions):a). average Bristol stool type of 1 - 4 AND frequency of 1 - 3 spontaneous bowel movements (SBMs) per week b). plus at least ONE of: straining on at least 25% of defaecations; sensation of incomplete evacuation on at least 25% of defaecations; sensation of anorectal obstruction / blockage on at least 25% of defaecations; use of manual manoeuvres on at least 25% of defaecations
  • Cleveland Clinic constipation score (CCCS) of 8-20
  • Low-moderate fiber intake (≤18g) determined by the semi-quantitative food intake screener known as the Block Fiber Screener
  • Ability to understand the patient information sheet and instructions in Dutch, and able to provide informed consent

Exclusion Criteria:

  • Subjects who report lactose intolerance and/or are allergic to soy or cow milk protein
  • Pregnant or breast-feeding women
  • Ongoing other diagnosed gastrointestinal disease or complication (Crohn's disease, Coeliac disease, chronic diarrhoea)
  • Any clinical relevant abnormalities in the screening visit medical examination or alarm features such as sudden unintentional weight loss, rectal bleeding, recent change in bowel habit (<3 months), abdominal pain and stool positive for occult blood
  • Prior abdominal surgery (including gastric bypass or laparoscopic banding), except cholecystectomy and appendicectomy
  • Neurologic diseases such as multiple sclerosis, stroke, spinal cord injury, Hirschsprung disease
  • Chronic medication that in opinion of the investigator would impact gut motility
  • Illness that may preclude the subject's ability to complete the study or that may confound the study outcomes (e.g. bowel cancer, prostate cancer, terminal illness, severe cardiovascular disease, chronic renal failure or eating disorders) or any other serious illness resulting in >2 weeks inability to work in the 3 months before the study start
  • Subjects with co-morbid illnesses such as cardiovascular, endocrine, renal or other chronic disease likely to affect gut motility or limit normal functions (e.g. reduced mobility or increased fragility)
  • Ongoing alcohol, drug, or medication abuse (anamnesis only)
  • Self-reported symptoms of pelvic organ prolapse
  • Moderate or severe active local anorectal problems such as recurrent anal fissures, bleeding, large prolapsing haemorrhoids
  • Regular use of fiber supplementation (e.g. Fybogel, Lactulose) (i.e. no more than 1 standard dose) over the week prior to the screening visit and no more than 6 standard doses in the past 1 month prior to the screening visit
  • Participation in another study with any investigational product within 3 months of screening
  • Investigator believes that the participant is physically or mentally unfit to participate in the trial

Sites / Locations

  • Julius Clinical

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

High quantity fiber food product

Low quantity fiber food product

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Whole gut transit time
To evaluate change in whole gut transit time 2 weeks after consumption of the study product in constipated patients consuming the study product containing fiber in high quantity, compared to those consuming placebo

Secondary Outcome Measures

Gastrointestinal symptoms
To evaluate change in Gastrointestinal symptoms 2&4 weeks after consumption of the study product in all groups
Regional colonic transit time
To evaluate change in the regional (right colon, left colon, and rectosigmoid tranist time 2 weeks after consumption of the study product in all groups
Whole gut transit time
To evaluate change in whole gut transit time 2 weeks after consumption of the study product in constipated patients consuming the study product containing fiber in low quantity, compared to those consuming placebo
Tolerance
To assess tolerance to the study product 1&2&4 weeks after consumption in all groups, using a questionnaire

Full Information

First Posted
September 2, 2014
Last Updated
November 9, 2015
Sponsor
Société des Produits Nestlé (SPN)
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1. Study Identification

Unique Protocol Identification Number
NCT02234518
Brief Title
Fibers and Gut Health
Official Title
Evaluation of Changes in Gut Transit Time and Gastrointestinal Symptoms Following the Consumption of a Fiber Containing Product in Adults With Constipation
Study Type
Interventional

2. Study Status

Record Verification Date
November 2015
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Société des Produits Nestlé (SPN)

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Gastrointestinal discomfort regularly affects >25% of the population worldwide. One of the major contributors to GI discomfort is constipation, which has a prevalence of ~15% and symptoms of which have a significant negative impact on the sufferer's quality of life. One of the hallmarks of chronic constipation is slow progression of contents through the gut (i.e. slow gut / colonic transit time), which may be associated with hard stools that are difficult to expel. Dietary fiber supplements are widely used as a first-line treatment for constipation although little Level 1 evidence exists to support its use in adults. The effectiveness of different fiber supplements is difficult to compare given wide differences in water-retention capabilities and effects on the colonic microbial ecology. Given the promising, yet largely unsubstantiated, benefits of fiber supplementation on symptoms of functional constipation, the objective of this clinical trial is to evaluate tolerance and effectiveness of four week supplementation of a fiber product, in a dose-ranging fashion, on whole gut transit time and gastrointestinal symptoms in adults with functional constipation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Constipation

7. Study Design

Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
120 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
High quantity fiber food product
Arm Type
Experimental
Arm Title
Low quantity fiber food product
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Other
Intervention Name(s)
High quantity fiber
Intervention Description
The intervention type is food product
Intervention Type
Other
Intervention Name(s)
Low quantity fiber
Intervention Description
The intervention type is food product
Intervention Type
Other
Intervention Name(s)
Placebo
Primary Outcome Measure Information:
Title
Whole gut transit time
Description
To evaluate change in whole gut transit time 2 weeks after consumption of the study product in constipated patients consuming the study product containing fiber in high quantity, compared to those consuming placebo
Time Frame
After 2 weeks consumption of the study product
Secondary Outcome Measure Information:
Title
Gastrointestinal symptoms
Description
To evaluate change in Gastrointestinal symptoms 2&4 weeks after consumption of the study product in all groups
Time Frame
After 2&4 weeks consumption of the study product
Title
Regional colonic transit time
Description
To evaluate change in the regional (right colon, left colon, and rectosigmoid tranist time 2 weeks after consumption of the study product in all groups
Time Frame
After 2 weeks consumption of the study product
Title
Whole gut transit time
Description
To evaluate change in whole gut transit time 2 weeks after consumption of the study product in constipated patients consuming the study product containing fiber in low quantity, compared to those consuming placebo
Time Frame
After 2 weeks consumption of the study product
Title
Tolerance
Description
To assess tolerance to the study product 1&2&4 weeks after consumption in all groups, using a questionnaire
Time Frame
After 1&2&4 weeks consumption of the study product
Other Pre-specified Outcome Measures:
Title
Adverse Events
Description
Adverse events assessed as treatment emergent adverse events (TEAEs)
Time Frame
Through the study product consumption period (4 weeks)
Title
Gut Health Insight Survey
Description
To gain insights into patient-specific constipation symptomology
Time Frame
At screening, after informed consent

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Men or women aged 18-75; female subjects of child-bearing potential must be willing to use a reliable method of contraception throughout the study period BMI: 18.5 - 29.9 kg/m2 Recruitment based on simplified core ROME III diagnostic criteria for functional constipation (based on specific screening questions):a). average Bristol stool type of 1 - 4 AND frequency of 1 - 3 spontaneous bowel movements (SBMs) per week b). plus at least ONE of: straining on at least 25% of defaecations; sensation of incomplete evacuation on at least 25% of defaecations; sensation of anorectal obstruction / blockage on at least 25% of defaecations; use of manual manoeuvres on at least 25% of defaecations Cleveland Clinic constipation score (CCCS) of 8-20 Low-moderate fiber intake (≤18g) determined by the semi-quantitative food intake screener known as the Block Fiber Screener Ability to understand the patient information sheet and instructions in Dutch, and able to provide informed consent Exclusion Criteria: Subjects who report lactose intolerance and/or are allergic to soy or cow milk protein Pregnant or breast-feeding women Ongoing other diagnosed gastrointestinal disease or complication (Crohn's disease, Coeliac disease, chronic diarrhoea) Any clinical relevant abnormalities in the screening visit medical examination or alarm features such as sudden unintentional weight loss, rectal bleeding, recent change in bowel habit (<3 months), abdominal pain and stool positive for occult blood Prior abdominal surgery (including gastric bypass or laparoscopic banding), except cholecystectomy and appendicectomy Neurologic diseases such as multiple sclerosis, stroke, spinal cord injury, Hirschsprung disease Chronic medication that in opinion of the investigator would impact gut motility Illness that may preclude the subject's ability to complete the study or that may confound the study outcomes (e.g. bowel cancer, prostate cancer, terminal illness, severe cardiovascular disease, chronic renal failure or eating disorders) or any other serious illness resulting in >2 weeks inability to work in the 3 months before the study start Subjects with co-morbid illnesses such as cardiovascular, endocrine, renal or other chronic disease likely to affect gut motility or limit normal functions (e.g. reduced mobility or increased fragility) Ongoing alcohol, drug, or medication abuse (anamnesis only) Self-reported symptoms of pelvic organ prolapse Moderate or severe active local anorectal problems such as recurrent anal fissures, bleeding, large prolapsing haemorrhoids Regular use of fiber supplementation (e.g. Fybogel, Lactulose) (i.e. no more than 1 standard dose) over the week prior to the screening visit and no more than 6 standard doses in the past 1 month prior to the screening visit Participation in another study with any investigational product within 3 months of screening Investigator believes that the participant is physically or mentally unfit to participate in the trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Diederick E. Grobbee, Prof, MD, PhD
Organizational Affiliation
Julius Clinical
Official's Role
Principal Investigator
Facility Information:
Facility Name
Julius Clinical
City
Zeist
ZIP/Postal Code
3703 CD
Country
Netherlands

12. IPD Sharing Statement

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Fibers and Gut Health

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