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Comparing the Effectiveness of Two Dietary Interventions for Fecal Incontinence

Phase 2
Completed
Conditions
Fecal Incontinence
Interventions
Dietary Supplement: Psyllium
Other: low fodmap diet
Registration Number
NCT02828384
Lead Sponsor
University of Michigan
Brief Summary

Background:

Fecal incontinence (FI) is a common complaint, and is often associated with diarrhea and urgency. Foods that are high in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAPs) cause symptoms of diarrhea and urgency. Thus, assessing the impact of a low FODMAP diet in FI patients is needed.

Aims:

1. Compare the treatment response with a low FODMAP vs. psyllium based on number of episodes in patients with FI.

2. Compare the efficacy of a low FODMAP diet vs. psyllium in patients with FI on pre-specified clinical and quality of life endpoints.

Methods:

This is a prospective, randomized control trial of adults meeting the Rome III criteria for FI and at least 1 episode of FI due to loose stool per week. After a 2 week screening period and randomization, during which the severity of symptoms will be assessed and eligibility determined, patients will be randomized to psyllium vs. low FODMAP diet for 4 weeks. A total of 20 patients will be recruited for each arm.

The primary endpoint will be treatment response based on number of incontinence episodes. A treatment response is defined as a reduction in the number of FI episodes/week.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
psylliumPsylliumsubjects receive 7.1 g of psyllium daily
low fodmap dietlow fodmap dietSubjects receive formalized teaching in low fodmap diet by a dietician
Primary Outcome Measures
NameTimeMethod
Change in number of FI episodes from baseline to week 44 weeks from baseline

Will compare baseline number of FI episodes to number of FI episodes at week 4

Secondary Outcome Measures
NameTimeMethod
Change in Fecal incontinence quality of life measure (FIqol)4 weeks from baseline

Compare baseline fecal incontinence quality of life with 4 week Fiqol score

number of people responding with decreased score in stool consistency4 week span from baseline

For stool consistency, a responder with improvement will be defined as one who reports a decrease in mean daily BSFS value ( on a scale of 1-7 with 7 being watery stool) of 1 or more compared to baseline for ≥2 of 4 treatment weeks. The proportion of responders between the 2 groups will be compared.

Change in Fecal incontinence severity index (FISI)4 weeks from baseline

Compare baseline fecal incontinence severity index with 4 week FISI score.

Change in Short Form Health survey-364 weeks from baseline

Compare baseline generalized QOL with 4 week SF-36

Number of participants with reduction in fecal incontinence episodes of ≥50% during weeks 3 & 4 of each diet compared with baseline4 weeks from baseline

Responders are those participants with a reduction in FI episodes of \> 50%. The reduction will be measured by the change in mean number of episodes in week 3 and 4 (averaged) from baseline.

number of people responding with reduction in stool frequency4 weeks from baseline

The number of bowel movements will be recorded each day. Mean daily stool frequency will be averaged for each treatment group at baseline and weekly through week 4. These averages will be compared for the two groups.

Change in stool wet weight4 weeks from baseline

The difference in stool mean wet weight between baseline and during week 4 will be calculated. The change from baseline for each group will be compared.

Trial Locations

Locations (1)

University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

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