Irritable Bowel Syndrome Clinical Trial
Official title:
Comparing the Effectiveness of Two Diets to Control the Symptoms of Irritable Bowel Syndrome With Diarrhea (IBS-D): a Randomized, Controlled Trial and Gastrointestinal Microbiome Analysis
The purpose of the study is to find out if the diets often recommended for patients with Irritable Bowel Syndrome with diarrhea (IBS-D) provide adequate relief. The study will compare two diets that are used to treat IBS-D symptoms to see which one is more effective. The study will also measure the effect of these diets on the bowel flora, which are the good bacteria that inhabit the bowels in healthy people.
As irritable bowel syndrome (IBS) symptoms are often refractory to conventional therapies,
there has been increasing interest in the role of diet in IBS. Certain foods may exacerbate
symptoms of IBS. Thus, restricted diets have recently gained attention for the treatment
IBS. The mechanism by which symptoms are improved is unclear, but these diets may improve
symptoms by exerting changes on the GI microbiome.
Aims:
Primary Objective:
-Compare the proportion of patients with irritable bowel syndrome (IBS-D) reporting adequate
relief on Diet 1 vs Diet 2
Secondary Objectives:
- Assess the effects of these diets in patients with diarrhea-predominant IBS on the
gastrointestinal microbiota and blood based biomarkers.
- Compare the efficacy of Diet 1 vs Diet 2 in patients with diarrhea-predominant IBS on
pre-specified clinical and quality of life endpoints.
Methods:
This is a prospective randomized control trial of adults meeting the Rome III criteria for
irritable bowel syndrome with diarrhea (IBS-D). After a 2 week screening period and
randomization, during which the severity of symptoms will be assessed and eligibility
determined, patients will be randomized to Diet 1 vs Diet 2 for a period of 4 weeks.
The primary endpoint will be a comparison of the proportion of patients in each group
reporting adequate relief of their IBS symptoms. For the secondary clinical outcomes, a
responder definition incorporating abdominal pain and stool consistency as proposed by the
FDA will be utilized. Key IBS-D symptoms will be assessed daily and adequate relief of IBS-D
symptoms will be assessed weekly during the randomization period. We will also determine if
a difference can be detected with high probability in the relative abundance and variety of
specific bacterial taxa between the two groups before and after the 4 week dietary
intervention. In addition, blood samples will be collected before and after randomization to
measure relevant biomarkers of immune activation.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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