This is a multi-center, randomized, double-blinded placebo controlled trial to evaluate the efficacy and safety of the substance-based medical device (Sollievo Fisiolax) in the treatment of Chronic Constipation. Treatment period for each patient is 28 days.
According to the criteria of Rome IV, 86 patients diagnosed from chronic constipation will be enrolled by up to ten centers. The study includes 2 visits at the site center and 1 by phone call. V-1 (eligibility assessment / screening visit): * Collection of written informed consent * Physical examination, including measurement of anthropometric parameters and vital signs (height, weight, diastolic / systolic pressure, heart rate) * Diagnosis according to Rome IV criteria of chronic functional constipation * Blood tests: glycemia, creatinine, complete blood count with formula, ALT, AST, ALP, calcium, potassium, sodium, C reactive protein, total bilirubin. Urinalysis. * Performing a colonoscopy for patients aged\> 50 who have not had one performed in the last 5 years. * Guideline for daily diary to collect the number and the consistency of the evacuations, and whether or not they occur with effort * Recording of adverse events and concomitant therapies V0 (confirmation of possession of selection criteria): * Physical examination, including measurement of anthropometric parameters and vital signs (height, weight, diastolic / systolic pressure, heart rate) * Randomization 1:1 to Sollievo Fisiolax or Placebo * Blood and fecal sample collection for the evaluations of the exploratory objectives * Compliance of the daily diary * Administration of questionnaires: Gastrointestinal Quality of Life Index (GIQLI), PAC-SYM * Any changes in concomitant therapies and any adverse events will be recorded. V1 (end of treatment or discontinuation before study / treatment time; 4 weeks after V0): * Physical examination, including measurement of anthropometric parameters and vital signs (height, weight, diastolic / systolic pressure, heart rate) * Returned the Investigational product * Blood and fecal sample collection for the evaluations of the exploratory objectives. * Blood tests: glycemia, creatinine, complete blood count with formula, ALT, AST, ALP, calcium, potassium, sodium, C reactive protein, total bilirubin. Urinalysis. * Blood sampling for the screening of HIV, HCV, HBV and TPHA * Check of daily diary * Administration of questionnaires: Gastrointestinal Quality of Life Index (GIQLI), PAC-SYM * Any changes in concomitant therapies and any adverse events will be recorded
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
86
Class IIb Medical Device
Placebo
Campus Biomedico
Rome, Lazio, Italy
RECRUITINGIRCCS Istituto Clinico Humanitas
Milan, Lombardy, Italy
RECRUITINGChange in the number of spontaneous complete bowel movement
Response rate (RR) to study treatment, defined by an increase of at least 1 spontaneous complete bowel movement, (SCBM) / weekly from baseline, in at least 75% of the weeks of the treatment period
Time frame: 28 days
Patient satisfaction
Composite rate of satisfaction with the treatment and improvement of the symptom complex, with "satisfaction" and "improvement" defined respectively by: * a ˃4 score on the following 7-point Likert scale of "satisfaction with treatment": 1. = extremely dissatisfied, 2. = very dissatisfied, 3. = dissatisfied, 4. = partially satisfied, 5. = satisfied, 6. = very satisfied, 7. = extremely satisfied * a score ≥2 on a global change rating scale (-7 to +7: -7 = extremely worsened, 0 = unchanged, +7 = extremely improved).
Time frame: 7 days, 14 days, 21 days, 28 days
Change in Stool frequency
Post treatment stool frequency increase respect to the Baseline
Time frame: through study completion, an average of 1 month
Change in Patient Assessment of Constipation-Symptom
Reduction of Patient Assessment of Constipation-Symptom (PAC-SYM) questionnaire, a 12-item questionnaire divided into three symptom subscales: abdominal (four items), rectal (three items) and stool (five items). Each item is scored on 5-point Likert scales, with scores ranging from 0 to 4 (0 = 'symptom absent', 1 = 'mild', 2 = 'moderate', 3 = 'severe' and 4 = 'very severe'). A score reduction represents an improvement of constipation symptoms.
Time frame: 14 days, 28 days
Change in Stool consistency
Change in the stool consistency assessed through the 7-point Bristol Stool Form Scale (type 1, type 2, type 3, type 4, type 5, type 6, type 7).
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Time frame: through study completion, an average of 1 month
Change of strain evacuation
Reduction of number of evacuation with strain
Time frame: through study completion, an average of 1 month
Rescue medication
Number of patients who used the rescue medication, nunmber of rescue medication consumed and frequency of use
Time frame: through study completion, an average of 1 month
Change of Quality of Life (QoL)
Improvement of QoL through Gastrointestinal Quality of Life Index questionnaire (GIQLI). GiQLI is a 36-item questionnaire, Each item is scored on 5-point Likert scales, with scores ranging from 0 to 4 (0 = 'all the time', 1 = 'most of the time', 2 = 'now and then', 3 = 'rarely' and 4 = 'never'). A score increase represents an improvement of QoL.
Time frame: 14 days, 28 days
Incidence of adverse events, serious adverse events, adverse device effects, serious adverse device effects, incidence of patients dropped outs.
Incidence of adverse events, serious adverse events, adverse device effects, serious adverse device effects, incidence of patients dropped outs.
Time frame: through study completion, an average of 1 month
Change of strain evacuation
Time to event (cox ratio), defined as the first week during which more than 50% of evacuations occurred without strain.
Time frame: through study completion, an average of 1 month