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Irritable Bowel SyndromeIBS-PlusNCT05013060

The Efficacy of Sodium Butyrate and Probiotics in Patients With Irritable Bowel Syndrome

A study testing Probiotics and microcapsulated sodium butyrate and Maltodextrin in people with Irritable Bowel Syndrome, run by Nordic Biotic Sp. z o.o. at 1 site in Poland.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

According to current IBS management guidelines, probiotic administration reduces IBS-associated symptoms and improves the quality of life. The purpose of this study is to assess the effects of the combined formulation comprising microencapsulated sodium butyrate and a probiotic mixture of two Lactobacillus strains (L. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Irritable Bowel Syndrome
What is being tested?
Probiotics and microcapsulated sodium butyrate and Maltodextrin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 sitePoland
Study dates
15 Apr 2021to 31 Jan 2024
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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males and females aged from 18 to 70 years, inclusive;
  • Good physical and mental condition assessed based on the patient's history and physical examination;
  • Laboratory test results (complete blood count, blood chemistry panel) within normal limits or considered not to be clinically significant by the Investigator; negative SARS-CoV-2 antibody test;
  • A voluntarily provided written informed consent;
  • Diagnosis of IBS based on the Rome IV criteria, e.g. recurrent abdominal pain at least one day a week for the last three months, associated with two or more of the following symptoms (these should be present for the last three months, with the onset of symptoms six months before diagnosis):
  • related to defecation
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  • associated with a change in stool frequency and/or
  • associated with a change in stool form (appearance)
  • Patients with any of the following forms of IBS will be included:
  • IBS-D - more than 25% of BSF type 6 and 7 stools, and less than 25% of type 1 and 2 stools.
  • IBS-C - more than 25% of BSF type 1 and 2 stools, with less than 25% of type 6 and 7 stools.
  • IBS-M - more than 25% of BSF type 6 and 7 stools and also more than 25% of type 1 and 2 stools.
  • at least moderate symptom severity defined as an IBS-SSS score of >175 (5 items, maximum score 500).
  • The following medications are allowed during this study, provided they have been used at a stable dose and for at least 1 month prior to the study:
  • contraceptive pills or intramuscular contraceptives,
  • hormone replacement therapy (estrogen/progesterone),
  • L-thyroxine,
  • antidepressants at low doses (up to 25 mg of amitriptyline, nortriptyline, or selective serotonin reuptake inhibitor per day)
  • antihypertensives at low doses (diuretics, angiotensin converting enzyme inhibitors angiotensin receptor antagonists).

Who cannot join

  • Unclassified IBS;
  • Cardiovascular disorders: uncontrolled hypertension (blood pressure >170/100 mmHg), cerebrovascular disease;
  • Respiratory disorders (asthma, chronic obstructive pulmonary disease [COPD]).
  • Hepatic impairment (including status post cholecystectomy), renal impairment, and unexplained blood biochemistry abnormalities: serum creatinine levels over twice the upper limit of normal, AST or ALT levels over twice the upper limit of normal.
  • Gastrointestinal conditions other than IBS, including clinical or endoscopic diagnosis of gastroenteritis.
  • Endocrine disorders, including diabetes mellitus (fasting blood glucose >11 mmol/L) and elevated TSH levels.
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  • Severe neurological conditions, with psychosis;
  • Malignancy;
  • Pregnancy or breastfeeding;
  • Hypersensitivity to soy;
  • Lactose intolerance;
  • The use of gastrointestinal motility stimulants or dietary fiber supplements during the 2 weeks preceding the clinical study;
  • The use of antithrombotic drugs;
  • A surgical procedure scheduled during the course of the clinical study;
  • Current probiotic use and refusal to undergo a 3-month washout period;
  • Antibiotic therapy during the 3 months preceding the study;
  • Antibiotic use during the study;
  • Being included in another clinical study during the previous 3 months;
  • History of alcohol or substance;
  • Inability to strictly adhere to the Investigators' instructions regarding study procedures and protocol requirements.abuse.

Trial locations and contacts

1 site in 1 country.

Poland1 site
  • Medical University of Lodz

    Lodz, 90-647

Other trials in Poland

About this study

Official title: An Assessment of the Efficacy of Microencapsulated Sodium Butyrate and a Probiotic Mixture in Patients With Irritable Bowel Syndrome - a Randomized Double-blind Placebo-controlled Study

According to current IBS management guidelines, probiotic administration reduces IBS-associated symptoms and improves the quality of life. The purpose of this study is to assess the effects of the combined formulation comprising microencapsulated sodium butyrate and a probiotic mixture of two Lactobacillus strains (L. rhamnosus and L. acidophilus) and three Bifidobacterium strains (B. longum, B. bifidum, and B. lactis) on the incidence and severity of clinical symptoms in patients diagnosed with irritable bowel syndrome (IBS) based on the Rome IV criteria.

Microencapsulated sodium butyrate is a short-chain fatty acid (SCFA) with biological effects on the gastrointestinal mucosa; it constitutes a key source of energy for enterocytes. Butyrate was shown to have a trophic effect on the colon epithelium and to help restore the disrupted structural and functional integrity of the gastrointestinal tract. These unique properties of sodium butyrate result in its beneficial effects on the abdominal symptoms (such as diarrhea, constipation, abdominal pain) in patients with IBS. This study will assess the effects of the mixture of sodium butyrate and multi-strain probiotic on the rate and severity of clinical symptoms in IBS patients, by taking into account their nutritional status and body composition.

Read the detailed description

The study schedule includes five visits:the screening/baseline visit, whose purpose is to qualify patients to be included in the study, the randomization visit (visit 0), at which patients will be given a probiotic/butyric acid or placebo, and three follow-up visits (at weeks 4, 8, and 12 after randomization).

All patients will undergo:

  1. A physical examination - at each visit;
  2. Nutritional status assessment - at visit 0 and at weeks 4 and 12 of treatment;
  3. Anthropometric measurements - at visit 0 and at weeks 4 and 12 of treatment;
  4. Body composition analysis via bioelectrical impedance analysis (BIA) with the use of a Bodystat machine - at visit 0 and at 4 and 12 weeks of treatment;
  5. Laboratory tests (including complete blood count; liver function tests; bilirubin, amylase, creatinine, CRP, and glucose levels; electrolytes; and an SARS-CoV2 antigen cassette test conducted by a doctor) at the screening visit; and cytokines (IL-6 and macrophage inflammatory protein 1β (MIP-1ß)) at visit 0 and at weeks 4 and 12 of treatment;
  6. Disease severity will be rated with the IBS symptom severity score (IBS-SSS) developed by Francis, Morris, and Whorwell, with mild, moderate, and severe cases indicated by scores of <175, 175-300, and >300, respectively. In addition, the following scales will be used to assess IBS treatment efficacy: IBS-Quality of Life (IBS-QOL), IBS-Global Improvement Scale (IBS-GIS), and IBS - Adequate Relief (IBS-AR).
  7. The number and type of bowel movements will be assessed with the Bristol Stool Formation scale.
Being tested
Probiotics and microcapsulated sodium butyrate, Maltodextrin
Keywords
Probiotics, Butyric acid, Microencapsulated sodium butyrate
Medical subject headings
Irritable Bowel Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Probiotics and microcapsulated sodium butyrateDietary supplement

    The patients who give their consent to take part in this study, will receive an oral microencapsulated sodium butyrate and a mixture of probiotics formulation 2 times a day for a period of 12 weeks.

  • MaltodextrinDietary supplement

    The patients who give their consent to take part in this study will receive an oral maltodextrin as placebo 2 times a day for a period of 12 weeks.

Study groups in NCT05013060
Study groupRoleWhat they receive
The mixture of probiotics and microcapsulated sodium butyrateActive comparatorOne billion of the following strains: Bifidobacterium lactis FloraActive 32269, Bifidobacterium longum FloraActive 32946, Bifidobacterium bifidum FloraActive 32043, Lactobacillus rhamnosus FloraActive 19070-2, Lactobacillus acidophilus FloraActive 32418 and 150 mg microcapsulated sodium butyrate, and 64 mg fructooligosaccharides
Receives: Dietary Supplement: Probiotics and microcapsulated sodium butyrate
PlaceboPlacebo comparatorMaltodextrin
Receives: Dietary Supplement: Maltodextrin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes in severity of IBS symptoms using IBS Severity Scoring System (IBS-SSS)

    IBS-SSS is a 5-question survey that asks: 1. the severity of abdominal pain, 2. frequency of abdominal pain, 3. severity of abdominal distention, 4.dissatisfaction with bowel habit, and 5. interference with quality of life over the past 10 days. Subjects respond to each question on a 100-point visual analogue scale. Each of the five question generates a maximum score of 100 point, and total scores can range from 0-500 with higher scores indicating severe symptoms.

    Measured: Severity of symptoms from baseline at 4, 8 and 12 weeks of intervention

  2. Improvement or worsening of IBS global symptoms using Global Improvement Scale (IBS-GIS)

    IBS-Global Improvement Scale asseses IBS symptoms using a patient-defined 7 point Linkert scale ranging from symptoms substantially worse to substantially improved.

    Patients answer the question "Have you felt any change in the severity of your symptoms over the past 7 days compared to how you felt before the medicine was given?

    The answers are recorded based on the 7-point scale:

    1. = I feel that the symptoms have worsened significantly
    2. = I feel that the symptoms have moderately worsened
    3. = I feel that the symptoms have slightly worsened
    4. = I feel no change
    5. = I feel a slight improvement
    6. = I feel moderate improvement
    7. = I feel significant improvement IBS-GIS score indicates: improvement if is >4 or worsening if is<4, no change if is 4.

    Measured: Improvement/worsening assessed after 4, 8 and 12 weeks of intervention

  3. Changes in an adequate relief

    IBS-Adequate Relief (IBS-AR) is a dichotomous single item that asks participants "Over the past week (7 days) have you had adequate relief of your IBS symptoms? The answer is YES or NO.

    Measured: Adequate Relief after 4, 8 and 12 weeks of interventions

  4. Changes in Quality of Life

    The IBS-Quality of Life (IBS-QOL) is a 34-item measure assessing the degree to which IBS interferes with patient quality of life. Each item is rated on a 5-point Likert scale, thus yielding a total score that has a theoretical range of 34 to 170, with higher scores indicating worse QOL.

    Measured: Quality of Life from baseline at 4, 8 and 12 weeks of intervention

Secondary outcomes (5)
  1. Changes in number and type of stools

    Number of stools per day and type of stools assessed before intervention and then 3 times a week. Type of stools assessed using the Bristol Stool Formation Scale. Bristol Scale is designed to classify faeces into seven groups: type 1-2 indicate constipation, type 3-4 are "normal" stools; type 5-7 indicate diarrhea.

    Measured: From baseline for 12 weeks of intervention in 1 week intervals

  2. Changes in severity of pain

    The severity of pain assessed before intervention and then 3 times a week using a patient-defined 5 point Linkert scale: point 0 - no pain, and 1-4 the severity of pain with higher scores indicating worse pain.

    Measured: From baseline for 12 weeks of intervention in 1 week intervals

  3. Changes in flatulence/abdominal distension

    The severity of flatulence/abdominal distension assessed before intervention and then 3 times a week using a patient-defined 5 point Linkert scale: point 0 - no flatulence/abdominal distension, and 1-4 the severity of flatulence/abdominal distension with higher scores indicating worse flatulence/abdominal distension.

    Measured: From baseline for 12 weeks of intervention in 1 week intervals

  4. Changes in Body Mass Index (BMI)

    The effect of intervention on the patient's weight

    Measured: From baseline at 4 and 12 weeks of intervention

  5. Body composition analysis

    Body composition will be measured via bioelectrical impedance analysis with the use of a Bodystat machine.

    Measured: From baseline at 4 and 12 weeks of intervention

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Aug 2021
  2. Study start15 Apr 2021
  3. Primary completion30 Sep 2023
  4. Study completion31 Jan 2024

Resources

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
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05013060
Sponsor's protocol ID
CT/NB/110/2019/PR-MS-PS
Acronym
IBS-Plus
Status last verified
Feb 2024
First submitted
13 Aug 2021
Last updated
28 Feb 2024
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Lee CC, Kono T, Syed F, Weaver SA, Sohn P, Wu W, Chang G, Liu J, Slak Rupnik M, Evans-Molina C. Sodium butyrate prevents cytokine-induced beta-cell dysfunction through restoration of stromal interaction molecule 1 expression and activation of store-operated calcium entry. FASEB J. 2024 Aug 15;38(15):e23853. doi: 10.1096/fj.202302501RR.

    PubMed 39120544
  • Gasiorowska A, Romanowski M, Walecka-Kapica E, Kaczka A, Chojnacki C, Padysz M, Siedlecka M, Bierla JB, Steinert RE, Cukrowska B. Effects of Microencapsulated Sodium Butyrate, Probiotics and Short Chain Fructooligosaccharides in Patients with Irritable Bowel Syndrome: A Study Protocol of a Randomized Double-Blind Placebo-Controlled Trial. J Clin Med. 2022 Nov 7;11(21):6587. doi: 10.3390/jcm11216587.

    PubMed 36362815

Questions about this trial

What is this clinical trial studying?

A study testing Probiotics and microcapsulated sodium butyrate and Maltodextrin in people with Irritable Bowel Syndrome, run by Nordic Biotic Sp. z o.o. at 1 site in Poland.

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 19 inclusion and 20 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: finished, as of the sponsor's last update on 28 Feb 2024. 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 Poland. 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. Some participants in this study may receive a placebo. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in severity of IBS symptoms using IBS Severity Scoring System (IBS-SSS) (time frame: Severity of symptoms from baseline at 4, 8 and 12 weeks of intervention). The study lists 4 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 NCT05013060, which also lists 2 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 28 Feb 2024.

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