To determine the effect on tolerance and gas production from chronic feeding of fermentable fibre (inulin) incorporated into a gel forming fibre (methylcellulose) compared with placebo (maltodextrin)
Our challenge is to understand how various dietary fibres interact to alter colonic fermentation of FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) with the aim of reducing gaseous distension of the colon and hence symptoms. Our previous studies have shown how psyllium, a gel forming natural fibre can reduce gas production induced by a dietary FODMAP inulin when it reaches the colon. The investigators are exploiting a range of food grade modified celluloses which can form gels at body temperature to perform human studies to explore whether the beneficial effect of psyllium is unique or will be found with all gelling substances 2. The investigators have completed a study using a modified methylcellulose which was shown to be non-inferior to psyllium. Our previous studies point to the importance of habitual FODMAP intake which is likely to alter the microbiota, selecting those that can efficiently utilise fructans. The investigators want to understand whether chronic feeding of inulin along with methylcellulose, a gel-forming dietary fibre which persists in the colon, will significantly alter the tolerance to inulin relative to chronic feeding of inulin with a suitable placebo maltodextrin. Maltodextrin is rapidly absorbed in the small bowel and therefore has no effect on colonic fermentation. The investigators plan to run a chronic feeding study in IBS patients and wish to ascertain tolerability of repeated use as previous studies have only provided single doses. With this in mind, the investigators plan to provide inulin and methylcellulose for daily consumption by healthy adults for a period of two weeks. The intervention will be divided into 3 portions to be taken before breakfast, lunch and supper. In week 1, the portions will contain 2.5 g of both inulin and methylcellulose in 62.5 mL water. In week 2, the portions will contain 5.0 g of both inulin and methylcellulose in 125 mL water. The participants will also follow the same chronic feeding schedule but with a maltodextrin placebo as opposed to methylcellulose, with randomisation of study schedule taking place at screening. The investigators will use MRI at baseline and at 2 weeks to assess changes in colonic volume and transit utilising high MRI contrast capsules54. The investigators will collect stool samples at baseline and after 1 and 2 weeks of chronic feeding for each study intervention to monitor the expected changes in microbiota. The primary objective is to assess the fermentation of inulin given as a single 15g with or without methylcellulose from the breath hydrogen response at baseline and after the 2 weeks feeding. .
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
35
2.5 and 5 gm Methylcelllose heated to create a gel
2.5 and 5 gm inulin powder dissolved in water
2.5 and 5gm maltodextrin dissolved in water
Nottingham Digestive Disease Centre
Nottingham, Nottinghamshire, United Kingdom
RECRUITINGNottingham Digestive Diseases Centre
Nottingham, Please Choose..., United Kingdom
RECRUITINGBreath hydrogen 0-6 hours post ingestion
Area under curve (AUC) from time 0-6 hours (AUC 0-6) of breath hydrogen (ppm.hour) after consumption of inulin intake.
Time frame: 0-6 hours
Symptoms
1\) Self-reported symptom scores relating to gastrointestinal tolerance during 2-week chronic feeding period
Time frame: 14 days
Breath hydrogen
2\) Area under curve (AUC) of breath hydrogen and methane for period 0 - 24hr.
Time frame: 0-24 hours
Orocaecal transit
Time for breath hydrogen to rise \> 10ppm over baseline
Time frame: 0- 6 hours
Whole gut transit time
assessed by marker transit
Time frame: 0-7 days
Fecal microbiota
16s DNA analysis
Time frame: 1 and 2 weeks post dosing
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