IBD Clinical Trial
Official title:
Intestinal Microbiome and Psychological Correlates in Irritable Bowel Syndrome and Inflammatory Bowel Disease
Longitudinal Investigation of intestinal microbiome, fecal inflammation markers, stress and psychological variables in patients with irritable bowel syndrome and inflammatory bowel disease undergoing gut-directed hypnotherapy (GHT).
Study design is a within-subject design with assessment at 4 points in time. Data will be
collected 3-1 month before first GHT session (T1), immediately before first session (T2), at
the last session (T3), and 3-6 months after last session (T4).
Study patients will be recruited consecutively at the special outpatient-clinic for
psychosomatics at the division of Gastroenterology and Hepatology, department for Internal
Medicine III, University Hospital Vienna.
Patients undergo GHT in group setting, which has been shown to reduce irritable bowel
syndrome (IBS) symptoms and to increase psychological wellbeing. The GHT protocol used will
be the Manchester protocol of gut-directed hypnotherapy and consists of 10 weekly sessions
(45 minutes) with six up to eight patients per group over a treatment period of 12 weeks.
The following variables will be assessed using standardized questionnaires: anxiety and
depression (HADS-D), perceived stress (PSQ), resilience (CDRISC), and quality of life
(visual analogue scales). IBS symptoms will be captured by the IBS Severity Scoring System
(IBS-SSS), inflammatory bowel disease (IBD) disease activity via Harvey-Bradshaw-Index.
Additionally, medication intake and food supplements will be assessed.
Microbiome data will be gained by frozen stool samples, collected by patients at home.
Patients will be provided with a delivery kit to keep the samples frozen. Patients are asked
to collect the first stool of the day and not to change diet, medication and intake of
pre/probiotics during the hole study period, if possible (documented). At each time point
(T1-T4) patients are ask to bring two immediately frozen (stored in their home freezer)
double samples (2 stool samples within 1 week) to the hospital to be immediately stored at
minus 20 degree Celsius. If patients do not have a home freezer, stool will be collected and
frozen at the hospital.
Planned analyses comprise longitudinal and cross-sectional comparisons Intestinal
colonization will enter in the analyses according to an algorithm assigning values for an
increase or reduction of dysbiosis. Dysbiosis is hereby defined by the following markers:
reduction of fecal biodiversity, lowered occurrence of the species Bifidobacterium,
Lactobacillus and Faecalibacterium prausnitzi, increased occurrence of Enterobacteriaceae,
and a higher quotient Firmicutes:Bacteroidetes.
;
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Basic Science
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