A Multistrain Probiotic in Patients With Irritable Bowel Syndrome With Predominant Constipation

CEN Biotech80 enrolled

Overview

Probiotics efficacy is mainly assessed by subjective endpoints such as the FDA responder rate or global relief, which partly explain contradictory results obtained in clinical trials with probiotic bacteria. Objective biomarkers of IBS will allow to measure the efficacy of probiotics. In the case of IBS-C, serum resolvin-D1 appears to be an interesting candidate due to its non-invasive and discriminating character compared to a healthy population. It is, inversely correlated with the severity of symptoms. Resolvin-D1 modulates the duration and intensity of inflammation by regulating the transcription of cytokines, chemokines and their receptors as well as other proteins involved in inflammation. Resolvin D1 could serve as a predictor of probiotic response based on its baseline value.

Resolvin D1 levels will be measured in patients with IBS-C as defined by the Rome IV criteria before 6 and 12 weeks after supplementation with a mixture of probiotics. The progression of IBS-C symptoms will also be assessed throughout the study. The correlation with resolvin D1 levels and the severity of IBS symptoms will be investigated. The efficacy of the probiotic mixture in relieving the symptoms of IBS-C will be measured and compared based on the levels of resolvin D1.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Irritable Bowel Syndrome With Constipation

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Irritable Bowel Syndrome with constipation (IBS-C) according to Rome IV criteria ; * IBS-SSS between 175-300 in the last 10 days ; * Have experienced abdominal pain ≥ 40 according to the IBS-SSS questionnaire (abdominal pain item) during the last 10 days ; * Whose abdominal pain / discomfort has had a significant impact on daily life during the past 10 days (impact ≥2 on a 5-point likert scale (from 0: no impact to 5: extreme impact) ; * Ability to understand instructions and complete questionnaires Nurstrial APP. * Affiliate or beneficiary of a social security ; * Having given their free, informed and written consent. Exclusion Criteria: * CPRu \> 10 mg/l * Pregnant or breastfeeding woman, woman planning a pregnancy during the study period ; * Intolerance or proven food allergy ; * BMI \<18.5 kg / m2 or BMI\> 35 kg / m2 ; * Diagnosis or known history of IBS-D, IBS-M, or unclassified forms of IBS, or other gastrointestinal pathologies ; * With current first-line IBS-C treatment or second-line treatment ; * alternative non pharmacological treatment ; * Drug treatment affecting visceral sensitivity or intestinal transit ; * dietary modification (exclusion of FODMAPs, prebiotic) or lifestyle ; * Excessive smoking or drinking ; * Having or planning bariatric surgery, * With known pathologies affecting gut function ; * With a deviant eating behavior, * Treated with antibiotics in the 3 months preceding inclusion, * Under legal protection, * Already included in a clinical trial, * With severely impaired physical/psychological health may affect study participation.

Outcomes

Primary Outcomes

Change of the severity of IBS-C symptoms

Measured by the composite IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) system, compared to the baseline IBS-SSS value. Minimum : 0 (best condition) to maximum (worse condition): 500

Time frame: At weeks 0, 4, 8 and 12

Secondary Outcomes

Change of the severity of addominal pain

Mesured by the Abdominal pain domain of the IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) score compared to the baseline. Minimum (best condition) : 0 to maximum (worse condition): 100

Time frame: At weeks 4, 8 and 12

Change of the number of days with abdominal pain

Mesured by the Number of days with abdominal pain domain of the IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) score compared to the baseline. Minimum (best condition) : 0 to maximum (worse condition): 100

Time frame: At weeks 4, 8 and 12

Change of the severity of abdominal distension (bloating)

Mesured by the bloating-distension domain of the IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) score compared to the baseline. Minimum (best condition) : 0 to maximum (worse condition): 100

Time frame: At weeks 4, 8 and 12

Change of the satisfaction with bowel habits

Mesured by the satisfaction with bowel habits domain of the IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) score compared to the baseline. Minimum (best condition) : 0 to maximum (worse condition): 100

Time frame: At weeks 4, 8 and 12

Change of the IBS-related quality of life

Mesured by the IBS related quality of life domain of the IBS-SSS (Irritable Bowel Syndrome-Severity Scale Scoring) score compared to the baseline. Minimum (best condition) : 0 to maximum (worse condition): 100

Time frame: At weeks 4, 8 and 12

Global assessment of symptoms relief

Measured by the Subject's Global Assessment (SGA) of Relief, compared to the baseline

Time frame: At weeks 4, 8 and 12

Change of Resolvin-D1 levels

Blood measurement of resolvin-D1 compared to the baseline

Time frame: At weeks 8 and 12

Change of CPRu (C Reactive Protein-ultrasensitive) levels

Blood measurement of C Reactive Protein ultrasensitive compared to the baseline

Time frame: At weeks 8 and 12

Change of the intestinal microbiota

Biological parameter : Fecal microbiota measured by 16S rRNA gene sequencing compared to baseline

Time frame: At weeks 6 and 12

Change of the stool frequency

Patient-reported number of stools using an e-diary, compared to baseline

Time frame: At weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12

Change of the stools consistency

Patient-reported stools consistency by the Bristol Stool Scale, using an e-diary, compared to baseline

Time frame: At weeks 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12

Change of the Quality of Life

Measured by Medical Outcomes Study Short-Form General Health Survey Short Form-12 compared to baseline

Time frame: At weeks 4, 8 and 12

Change of number of drugs consumption to alleviate the IBS-C symptoms

Patient-reported drug (laxative, spasmolytics) consumption using an e-diary, compared to baseline

Time frame: At weeks 4, 8 and 12

Assessing the relationship between resolvin D1 levels and symptoms severity mesured by IBS-SSS symptoms scores

Regression analysis

Time frame: At week 12

Assessing the relationship between baseline resolvin D1 levels and response to the probiotics supplementation measured by the responders rate (outcome 17)

Regression analysis

Time frame: At week 12

Assessing the responders rate

Number of patients with a decrease in the weekly average of worst abdominal pain in the past 24 hours score (measured daily) of at least 30 percent compared with baseline weekly average and a stool Frequency Weekly Responder is defined as a patient who experiences an increase of at least one complete stool bowel movement per week from baseline.

Time frame: At weeks 4, 8 and 12

Assessing the relationship between baseline microbiota and response to the probiotics supplementation measured by the responders rate (outcome 17)

Regression analysis

Time frame: At week 12

Assessing the tolerance of the probiotics mixture

Adverse reactions analysis

Time frame: At weeks 6 and 12

Assessing the global improvement

Measured by the patient global impression of improvement

Time frame: At weeks 4, 8 and 12

Assessing the satisfaction regarding the mixture of probiotics

Measured by a 5 points Likert scale 0 : worse satisfaction to 5 : better satisfaction

Time frame: At weeks 4, 8 and 12

A Multistrain Probiotic in Patients With Irritable Bowel Syndrome With Predominant Constipation

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes