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Improved Quality of Life in Children With Intestinal Failure

Not Applicable
Completed
Conditions
Intestinal Pseudo-Obstruction
Malabsorption Syndrome Autoimmune Enteropathy
Short Bowel Syndrome
Bacterial Overgrowth
Interventions
Dietary Supplement: Stimulance
Registration Number
NCT04981262
Lead Sponsor
Oslo University Hospital
Brief Summary

Children with intestinal failure have a lack of tolerance for food in the intestine. The children are dependent on intravenous nutrition over a long period of time period to ensure growth and development. The condition is characterized by bacterial overgrowth in the intestine, with nausea, vomiting, diarrhea and flatulence as physical symptoms. Mental health is affected in the form of lower quality of life, lack of school participation and less social contact with peers. The investigators own (unpublished) data show that children with intestinal failure have a lower quality of life than healthy people. Standard treatment is antibiotics, but the effect of these is short-lived, and many must have repeated courses. Prebiotics are indigestible carbohydrates (fiber) in foods that positively affect the bacterial flora and promote intestinal health. In this project the investigators want to see if supply of prebiotics can change the bacterial balance, reduce symptoms of bacterial overgrowth and increase quality of life. The study is unique, as Prebiotics have not previously been used in the treatment of intestinal failure. If successful, it can pave the way for a new and better treatment method that can potentially be transferred to other conditions with imbalance in the intestinal flora. The study is a randomized intervention study and is consist of two phases. In phase 1, the effect of 4 weeks of open intervention with prebiotics is studied to establish so-called "proof of concept". Data from phase 1 are used to look at connections between the composition of intestinal flora, nutritional status and bowel function. The intervention involves the use of a prebiotic product (Stimulance, Nutricia), which is added to childs regular food. In phase 2, patients are randomized into two groups. One group will continue with the product for 6 months, while the other group does not receive prebiotics.

Detailed Description

Quality of life, gastrointestinal symptoms and family impact are measured using validated forms for four weeks before intervention phase 1, at start-up and after phase 1, as well as after phase 2. Stool samples are collected at the same time points. Weight, height is measured and blood tests are collected at the start and end of phases 1 and 2. Data on diet and nutritional treatment are collected at the start and end of the two phases. The stool samples are analyzed for short fatty acids (marker for good intestinal health), the composition of the intestinal flora and inflammation markers. Blood samples are analyzed for infection markers, intestinal health markers and nutritional markers. Nutritional data are analyzed for nutrient content and the dependence on nutritional support is calculated.

The investigators expect that the study will lead to an improved quality of life for the patient group through increased tolerance to food in the intestine, reduced antibiotic use and reduction of gastrointestinal symptoms. The project is patient-oriented.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
56
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Stimulance 6 monthsStimulance6 months intervention
StimulanceStimulance4 weeks intervention with Stimulance for all participants
Primary Outcome Measures
NameTimeMethod
Changes in gastro intestinal symptoms scores before and after treatment with prebiotics6 months

Pediatric quality of life inventory Gastro intestinal symptom scale scores on an analog scale from 0-100 where higher scores means better outcome

Changes in familt impact scores before and after treatment with prebiotics6 months

Pediatric quality of life inventory Family Impact Module scores on an analog scale from 0-100 where higher scores means better outcome

Changes in Quality of life scores before and after treatment with prebiotics6 months

Changes in Pediatric quality of life inventory scores on an analog scale from 0-100 where higher scores means better outcome

Secondary Outcome Measures
NameTimeMethod
Changes in Microbiota6 months

Measured by Short Chain Fatty Acids and microbiota composition

Trial Locations

Locations (1)

Oslo University Hopspital

🇳🇴

Oslo, Norway

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