Constipation - Functional
Conditions
Keywords
constipation
Brief summary
This study is a randomised, parallel group, controlled trial, comparing the effects of fruit products as to their physiological, microbiologic and metabolomic effects on the gut, as well as their effects on the dietary intake and quality in healthy people with constipation.
Interventions
OTHERFruit Products
Fruit Products with the potential to improve constipation-related outcomes
Sponsors
Queen Mary University of London
Imperial College London
King's College London
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Men and women aged 18-65 years. 2. Individuals meeting the Rome IV criteria for functional constipation, in addition to having \<7 bowel movements per week and hard or lumpy stools present in ⩾25% of their defecations (defined as Type 1 & 2 of the Bristol Stool Form Scale). 3. Individuals who are willing to consume fruit products for 4 weeks. 4. Individuals who consume \<30g of fibre per day 5. Individuals with a BMI of 18.5-29.99 kg/m2. 6. Individuals able to give informed consent.
Exclusion criteria
1. Females who report to be pregnant or lactating. 2. Regular consumers of the fruit products used in the intervention arm 1 (3 or more portions per week). 3. Allergy, intolerance or dislike of the fruit products used in this intervention. 4. Sulphite allergy or sensitivity. 5. Ongoing alcohol, drug or medication abuse. 6. Major medical condition (diabetes, psychiatric or current eating disorders), gastrointestinal disease (e.g. inflammatory bowel disease, coeliac disease) or history of previous GI surgery, except cholecystectomy, appendicectomy and haemorrhoidectomy. 7. Medications which affect their gut physiology, function and symptoms in the last 4 weeks, and individuals who are not willing or cannot discontinue them. 8. Frequent use of rescue laxatives.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in faecal weight between baseline and week 4 | week 4 | Change in 7-day faecal weight |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Faecal microbiome | week 0 and 4 | Ιndividual phyla, family, genera, species and strains of the faecal gut microbiome (absolute and change). |
| Faecal metabolomic profile | week 0 and 4 | Faecal metabolomic profile (absolute and change) measured using proton nuclear magnetic resonance |
| Urine metabolomic profile | week 0 and 4 | Urine metabolomic profile (absolute and change) measured using proton nuclear magnetic resonance |
| Faecal short-chain fatty acids | week 0 and 4 | Faecal short-chain fatty acids concentration (absolute and change) |
| Faecal water content | week 0 and 4 | Faecal water content (absolute and change) measured through lyophilisation |
| Faecal pH | week 0 and 4 | Faecal pH (absolute and change) |
| Stool output | week 0 and 4 | Assessed using 7-day diaries and the Bristol Stool Form Scale (absolute and change).. |
| Faecal microbiome diversity | week 0 and 4 | Global microbiota composition (α-diversity, β-diversity) |
| Gastrointestinal symptoms - PAC-SYM | week 0 and 4 | The validated questionnaire Patient Assessment of Constipation Symptoms (PAC-SYM) will be used (absolute and change). |
| Gastrointestinal symptom severity questionnaire - CCCS | week 0 and 4 | The validated questionnaire Cleveland Clinic Constipation Score (CCCS) will be used (absolute and change). |
| Dietary intake | week 0 and 4 | Dietary intake (absolute and change) will be recorded in 7-day food and drink diaries |
| Constipation-related quality of life | week 0 and 4 | Constipation-related quality of life (absolute and change) which will be measured with the condition-specific validated Patient Assessment of Constipation Quality of Life (PAC-Qol) questionnaire. PAC-QoL is a self-report 28-item tool that uses a 5-point Likert scale ranging from Not at all to Extremely. |
| Whole and regional gut transit time/pH | week 0 and 4 | Whole gut transit time and regional gut pH (absolute and change) will be assessed in a subset of participants (n=39), by using a motility capsule (SmartPill ®, Medtronic) |
| Acceptability of interventions | week 0 and 4 | Acceptability of the interventions measured using a questionnaire that included 3- and 4-point likert scales and open-text answers |
| Compliance | week 0 and 4 | Compliance to the study interventions will be measured using specific questions relevant to the intervention received in the food and drink diary completed at week 4, by regular phone calls with participants throughout the intervention period, and by the number of unconsumed fruit products returned by the participants after the end of the intervention. |
| Individual gastrointestinal symptoms | week 0 and 4 | The 7-day diaries contain a short questionnaire for each bowel movement to monitor completeness, spontaneity, straining and need for manual maneuvers. The validated Gastrointestinal Symptom Rating Scale will be used over a 7-day period |
Countries
United Kingdom
Contacts
Primary ContactZoi Katsirma, MSc
Backup ContactEirini Dimidi, MSc, PhD
Outcome results
None listed