Short Bowel SyndromePUPINCT04224168
Pectin Use in Pediatric Intestinal Rehabilitation
A study testing Green Beans and Liquid Pectin in people with Short Bowel Syndrome, run by Le Bonheur Children's Hospital at 1 site in United States.
Trial summary
Pediatric short bowel patients, age 6 months to 21 years old, followed in our intestinal rehabilitation clinic, will be screened for qualification in the study. If meets qualification, will be consented for the study. Read more about this study
- Who is it for?
- Ages 6 months to 21 years
- Conditions the study is for
- Short Bowel Syndrome
- What is being tested?
- Green Beans and Liquid Pectin
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 15 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Jan 2020to Jan 2021
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 6 months to 21 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Short bowel syndrome patients followed in CIRCLe
- >=50% of colon remaining
- Patients requiring only enteral feeds for nutrition
- >=6 months of age-21 years of age
Who cannot join
- Patients with major structural cardiac anomalies and/or end stage renal disease
- Patients with solid organ transplant
- Patients >24 months of age without gastric tube
- Short bowel patients on PN
Trial locations and contacts
1 site in 1 country.
United States1 site, 1 recruiting
- Recruiting
Le Bonheur Children's Hospital
Memphis, Tennessee, 38103
Meredith L Harvie, MD, 901-287-7337, mharvie@uthsc.edu
About this study
Official title: Pectin Use in Pediatric Intestinal Rehabilitation: Comparison Study of Liquid Pectin Versus Green Beans in Optimizing Enteral Nutrition in Short Bowel Syndrome Patients
Pediatric short bowel patients, age 6 months to 21 years old, followed in our intestinal rehabilitation clinic, will be screened for qualification in the study. If meets qualification, will be consented for the study. The study involves patients receiving green beans in their diet for three months with data collection including stooling patterns as well as labs, and then switching over to liquid pectin for three months. Again data collection will take place. The duration of the study once patient is consented is ~6 months.
Read the detailed description
This will be a modified cross over design. Patients who meet eligibility criteria, will be consented in their standard of care intestinal rehab clinic visit. Due to the fact that some patients who qualify for the study may already be on liquid pectin prior to the study, we will not be able to randomize all of the patients prior to starting the intervention. If a patient is on liquid pectin, they will stay on liquid pectin as their first intervention. If the patient is on no form of daily pectin, they will be randomized to either green beans or liquid pectin first. The patient will either be given Ball real fruit liquid pectin, 1g fiber/tsp, (mixed in formula or other liquid) via oral route or gastric tube (gtube) or Gerber stage two green bean baby food, 2gfiber/jar, via oral route or gtube. We will have patients stay on either Ball real fruit liquid pectin or Gerber stage 2 green beans for three months. After the three-month trial on one of the pectin formulation, they will switch to the other. However, we will not start collecting data until a week after the switch to allow for a washout period without compromising potential benefit that the patient was receiving. Each patient will receive 2g/kg of fiber per day(based on previous case reports) with a max of 6g/day. Patients will be followed in the Children's Intestinal Rehabilitation Clinic at Le Bonheur (CIRCLe). Standard of care follow up for short bowel syndrome patients is three months if they are doing well. During the three months, families will be contacted every 4 weeks via patient portal or phone call to ask specific questions on their current form of pectin, amount, days missed, ease/difficulty of administration and clinical symptoms. This will also serve as a reminder to the parents of what they should be providing to the child and will assist in optimizing data collection. After three months of being on one formulation of pectin, they will change to the other formulation and same follow up will occur. Stool output data collection will be delayed one week in between interventions as detailed above to allow for a "wash out" period. Standard of care also includes lab work (complete metabolic panel, magnesium, phosphorous, triglyceride, complete blood count with differential) at each 3 month visit. Trace minerals and soluble vitamins are usually collected annually, but for this study, will plan to obtain serum copper and iron levels after each intervention(x2). However, additional venous puncture will not be required. Therefore, data can be collected prior to intervention and following each intervention, then be compared between the groups. If able, we will collect stool samples from patients prior to intervention and after intervention to evaluate the microbiome. Recruitment in the study would be for a total period of six months. Interventions would be completed over a six month period. This allows us a total of 12 months for recruitment, intervention and data collection.
- Conditions
- Short Bowel Syndrome
- Being tested
- Green Beans, Liquid Pectin
- Medical subject headings
- Short Bowel Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Green BeansDietary supplement
Please see arm group Green beans for description
Liquid PectinDietary supplement
Please see arm group liquid pectin for description
| Study group | Role | What they receive |
|---|---|---|
| Green Beans | Experimental | Green beans will be provided in the daily diets of the patients enrolled for 3 months via gtube or oral means. Only up to 6g of fiber total from green beans will be given. This equates to 3x 4 ounce jars of green beans per day. Receives: Dietary Supplement: Green Beans |
| Liquid Pectin | Experimental | Liquid pectin will be provided in the daily diets of the patients enrolled for 3 months via gtube or oral means. Only up to 6g of fiber total from liquid pectin will be given. This equates to 6 teaspoons or 30mL of liquid pectin per day. Receives: Dietary Supplement: Liquid Pectin |
What is being measured
The primary outcome is the main question the study is designed to answer.
Weight gain
Z-score will be used to evaluate overall weight gain. This will standardize weight between ages. Weight will be taken prior to intervention and after each intervention.
Measured: 6 months
Stooling pattern
Will use postcards to characterize stooling consistency and amount of stool. They will be weekly postcards that are mailed back to the clinic. Will take the average consistency and amount each week and compare before and after each intervention.
Measured: 6 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Jan 2020
- Study start1 Jan 2020
- Primary completionJan 2021 (estimated)
- Study completionJan 2021 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Short Bowel SyndromeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 15 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Le Bonheur Children's Hospital
- Sponsor type
- University, hospital or other
- Collaborators
- University of Tennessee
- Responsible party
- Principal investigator, Meredith L Harvie, MD, Le Bonheur Children's Hospital
- Investigators
- Anushree Algotar, MBBS, Study chair, LeBonheur Children's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04224168
- Sponsor's protocol ID
- 19-06654-FB
- Acronym
- PUPI
- Status last verified
- Jan 2020
- First submitted
- 8 Jan 2020
- Last updated
- 13 Jan 2020
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Goulet O, Olieman J, Ksiazyk J, Spolidoro J, Tibboe D, Kohler H, Yagci RV, Falconer J, Grimble G, Beattie RM. Neonatal short bowel syndrome as a model of intestinal failure: physiological background for enteral feeding. Clin Nutr. 2013 Apr;32(2):162-71. doi: 10.1016/j.clnu.2012.09.007. Epub 2012 Sep 25.
PubMed 23159212Drenckpohl, D., et al., Adding Dietary Green Beans to Formula Resolves the Diarrhea Associated With a Bowel Resection in Neonates. ICAN: Infant, Child, & Adolescent Nutrition, 2013. 5(1): p. 8-13.
Wessel J, Kotagal M, Helmrath MA. Management of Pediatric Intestinal Failure. Adv Pediatr. 2017 Aug;64(1):253-267. doi: 10.1016/j.yapd.2017.03.010. No abstract available.
PubMed 28688591Rabbani GH, Teka T, Zaman B, Majid N, Khatun M, Fuchs GJ. Clinical studies in persistent diarrhea: dietary management with green banana or pectin in Bangladeshi children. Gastroenterology. 2001 Sep;121(3):554-60. doi: 10.1053/gast.2001.27178.
PubMed 11522739Harvie ML, Norris MAT, Sevilla WMA. Soluble Fiber Use in Pediatric Short Bowel Syndrome: A Survey on Prevailing Practices. Nutr Clin Pract. 2018 Aug;33(4):539-544. doi: 10.1002/ncp.10089. Epub 2018 May 16.
PubMed 29767462Drenckpohl D, Hocker J, Shareef M, Vegunta R, Colgan C. Adding dietary green beans resolves the diarrhea associated with bowel surgery in neonates: a case study. Nutr Clin Pract. 2005 Dec;20(6):674-7. doi: 10.1177/0115426505020006674.
PubMed 16306306Homann HH, Kemen M, Fuessenich C, Senkal M, Zumtobel V. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition. JPEN J Parenter Enteral Nutr. 1994 Nov-Dec;18(6):486-90. doi: 10.1177/0148607194018006486.
PubMed 7602722Becker B, Kuhn U, Hardewig-Budny B. Double-blind, randomized evaluation of clinical efficacy and tolerability of an apple pectin-chamomile extract in children with unspecific diarrhea. Arzneimittelforschung. 2006;56(6):387-93. doi: 10.1055/s-0031-1296739.
PubMed 16889120Koruda MJ, Rolandelli RH, Settle RG, Saul SH, Rombeau JL. Harry M. Vars award. The effect of a pectin-supplemented elemental diet on intestinal adaptation to massive small bowel resection. JPEN J Parenter Enteral Nutr. 1986 Jul-Aug;10(4):343-50. doi: 10.1177/0148607186010004343.
PubMed 3747092Rabbani GH, Teka T, Saha SK, Zaman B, Majid N, Khatun M, Wahed MA, Fuchs GJ. Green banana and pectin improve small intestinal permeability and reduce fluid loss in Bangladeshi children with persistent diarrhea. Dig Dis Sci. 2004 Mar;49(3):475-84. doi: 10.1023/b:ddas.0000020507.25910.cf.
PubMed 15139502Nakao M, Ogura Y, Satake S, Ito I, Iguchi A, Takagi K, Nabeshima T. Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Nutrition. 2002 Jan;18(1):35-9. doi: 10.1016/s0899-9007(01)00715-8.
PubMed 11827762
Study at a glance
From the registry record, last updated by the sponsor on 13 Jan 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Pectin Use in Pediatric Intestinal Rehabilitation: Comparison Study of Liquid Pectin Versus Green Beans in Optimizing Enteral Nutrition in Short Bowel Syndrome Patients
- ClinicalTrials.gov ID
- NCT04224168
- Acronym / sponsor ID
- PUPI / 19-06654-FB
- Conditions
- Short Bowel Syndrome
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 15 participants (estimated)
- Lead sponsor
- Le Bonheur Children's HospitalUniversity, hospital or other
- Collaborators
- University of Tennessee
- Study start
- 1 Jan 2020 (actual)
- Primary completion
- Jan 2021 (estimated)
- Study completion
- Jan 2021 (estimated)
- First posted
- 13 Jan 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Pediatric short bowel patients, age 6 months to 21 years old, followed in our intestinal rehabilitation clinic, will be screened for qualification in the study. If meets qualification, will be consented for the study. The study involves patients receiving green beans in their diet for three months with data collection including stooling patterns as well as labs, and then switching over to liquid pectin for three months. Again data collection will take place. The duration of the study once patient is consented is ~6 months.
Detailed description
This will be a modified cross over design. Patients who meet eligibility criteria, will be consented in their standard of care intestinal rehab clinic visit. Due to the fact that some patients who qualify for the study may already be on liquid pectin prior to the study, we will not be able to randomize all of the patients prior to starting the intervention. If a patient is on liquid pectin, they will stay on liquid pectin as their first intervention. If the patient is on no form of daily pectin, they will be randomized to either green beans or liquid pectin first. The patient will either be given Ball real fruit liquid pectin, 1g fiber/tsp, (mixed in formula or other liquid) via oral route or gastric tube (gtube) or Gerber stage two green bean baby food, 2gfiber/jar, via oral route or gtube. We will have patients stay on either Ball real fruit liquid pectin or Gerber stage 2 green beans for three months. After the three-month trial on one of the pectin formulation, they will switch to the other. However, we will not start collecting data until a week after the switch to allow for a washout period without compromising potential benefit that the patient was receiving. Each patient will receive 2g/kg of fiber per day(based on previous case reports) with a max of 6g/day. Patients will be followed in the Children's Intestinal Rehabilitation Clinic at Le Bonheur (CIRCLe). Standard of care follow up for short bowel syndrome patients is three months if they are doing well. During the three months, families will be contacted every 4 weeks via patient portal or phone call to ask specific questions on their current form of pectin, amount, days missed, ease/difficulty of administration and clinical symptoms. This will also serve as a reminder to the parents of what they should be providing to the child and will assist in optimizing data collection. After three months of being on one formulation of pectin, they will change to the other formulation and same follow up will occur. Stool output data collection will be delayed one week in between interventions as detailed above to allow for a "wash out" period. Standard of care also includes lab work (complete metabolic panel, magnesium, phosphorous, triglyceride, complete blood count with differential) at each 3 month visit. Trace minerals and soluble vitamins are usually collected annually, but for this study, will plan to obtain serum copper and iron levels after each intervention(x2). However, additional venous puncture will not be required. Therefore, data can be collected prior to intervention and following each intervention, then be compared between the groups. If able, we will collect stool samples from patients prior to intervention and after intervention to evaluate the microbiome. Recruitment in the study would be for a total period of six months. Interventions would be completed over a six month period. This allows us a total of 12 months for recruitment, intervention and data collection.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Green Beans | Experimental | Dietary Supplement: Green BeansGreen beans will be provided in the daily diets of the patients enrolled for 3 months via gtube or oral means. Only up to 6g of fiber total from green beans will be given. This equates to 3x 4 ounce jars of green beans per day. |
| Liquid Pectin | Experimental | Dietary Supplement: Liquid PectinLiquid pectin will be provided in the daily diets of the patients enrolled for 3 months via gtube or oral means. Only up to 6g of fiber total from liquid pectin will be given. This equates to 6 teaspoons or 30mL of liquid pectin per day. |
Who may qualify
- Ages
- 6 months to 21 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (4 listed)
- Short bowel syndrome patients followed in CIRCLe
- >=50% of colon remaining
- Patients requiring only enteral feeds for nutrition
- >=6 months of age-21 years of age
Key exclusion criteria (4 listed)
- Patients with major structural cardiac anomalies and/or end stage renal disease
- Patients with solid organ transplant
- Patients >24 months of age without gastric tube
- Short bowel patients on PN
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Green BeansPlease see arm group Green beans for description | Dietary supplement | Green Beans |
| Liquid PectinPlease see arm group liquid pectin for description | Dietary supplement | Liquid Pectin |
Primary outcome
Weight gain
Time frame: 6 months
Z-score will be used to evaluate overall weight gain. This will standardize weight between ages. Weight will be taken prior to intervention and after each intervention.
Stooling pattern
Time frame: 6 months
Will use postcards to characterize stooling consistency and amount of stool. They will be weekly postcards that are mailed back to the clinic. Will take the average consistency and amount each week and compare before and after each intervention.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Jan 2020.
- Background: PubMed 23159212Goulet O, Olieman J, Ksiazyk J, Spolidoro J, Tibboe D, Kohler H, Yagci RV, Falconer J, Grimble G, Beattie RM. Neonatal short bowel syndrome as a model of intestinal failure: physiological background for enteral feeding. Clin Nutr. 2013 Apr;32(2):162-71. doi: 10.1016/j.clnu.2012.09.007. Epub 2012 Sep 25.
- BackgroundDrenckpohl, D., et al., Adding Dietary Green Beans to Formula Resolves the Diarrhea Associated With a Bowel Resection in Neonates. ICAN: Infant, Child, & Adolescent Nutrition, 2013. 5(1): p. 8-13.
- Background: PubMed 28688591Wessel J, Kotagal M, Helmrath MA. Management of Pediatric Intestinal Failure. Adv Pediatr. 2017 Aug;64(1):253-267. doi: 10.1016/j.yapd.2017.03.010. No abstract available.
- Background: PubMed 11522739Rabbani GH, Teka T, Zaman B, Majid N, Khatun M, Fuchs GJ. Clinical studies in persistent diarrhea: dietary management with green banana or pectin in Bangladeshi children. Gastroenterology. 2001 Sep;121(3):554-60. doi: 10.1053/gast.2001.27178.
- Background: PubMed 29767462Harvie ML, Norris MAT, Sevilla WMA. Soluble Fiber Use in Pediatric Short Bowel Syndrome: A Survey on Prevailing Practices. Nutr Clin Pract. 2018 Aug;33(4):539-544. doi: 10.1002/ncp.10089. Epub 2018 May 16.
- Background: PubMed 16306306Drenckpohl D, Hocker J, Shareef M, Vegunta R, Colgan C. Adding dietary green beans resolves the diarrhea associated with bowel surgery in neonates: a case study. Nutr Clin Pract. 2005 Dec;20(6):674-7. doi: 10.1177/0115426505020006674.
- Background: PubMed 7602722Homann HH, Kemen M, Fuessenich C, Senkal M, Zumtobel V. Reduction in diarrhea incidence by soluble fiber in patients receiving total or supplemental enteral nutrition. JPEN J Parenter Enteral Nutr. 1994 Nov-Dec;18(6):486-90. doi: 10.1177/0148607194018006486.
- Background: PubMed 16889120Becker B, Kuhn U, Hardewig-Budny B. Double-blind, randomized evaluation of clinical efficacy and tolerability of an apple pectin-chamomile extract in children with unspecific diarrhea. Arzneimittelforschung. 2006;56(6):387-93. doi: 10.1055/s-0031-1296739.
- Background: PubMed 3747092Koruda MJ, Rolandelli RH, Settle RG, Saul SH, Rombeau JL. Harry M. Vars award. The effect of a pectin-supplemented elemental diet on intestinal adaptation to massive small bowel resection. JPEN J Parenter Enteral Nutr. 1986 Jul-Aug;10(4):343-50. doi: 10.1177/0148607186010004343.
- Background: PubMed 15139502Rabbani GH, Teka T, Saha SK, Zaman B, Majid N, Khatun M, Wahed MA, Fuchs GJ. Green banana and pectin improve small intestinal permeability and reduce fluid loss in Bangladeshi children with persistent diarrhea. Dig Dis Sci. 2004 Mar;49(3):475-84. doi: 10.1023/b:ddas.0000020507.25910.cf.
- Background: PubMed 11827762Nakao M, Ogura Y, Satake S, Ito I, Iguchi A, Takagi K, Nabeshima T. Usefulness of soluble dietary fiber for the treatment of diarrhea during enteral nutrition in elderly patients. Nutrition. 2002 Jan;18(1):35-9. doi: 10.1016/s0899-9007(01)00715-8.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Anushree Algotar, MBBS study chair
LeBonheur Children's Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Green Beans and Liquid Pectin in people with Short Bowel Syndrome, run by Le Bonheur Children's Hospital at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 13 Jan 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Meredith L Harvie, MD (901-287-7337, mharvie@uthsc.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Weight gain (time frame: 6 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04224168, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Jan 2020.