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Traditional Dietary Advice Versus Reassurance-alone in Postprandial Functional Dyspepsia

Not Applicable
Recruiting
Conditions
Dyspepsia
Functional Gastrointestinal Disorders
Interventions
Behavioral: Traditional dietary advice
Other: Reassurance-alone
Registration Number
NCT05718960
Lead Sponsor
Sheffield Teaching Hospitals NHS Foundation Trust
Brief Summary

Functional dyspepsia is common, affecting 7.2% of the global population, and associated with substantial health impairment. Almost 80% of patients with functional dyspepsia report meal-related symptoms and are classified as having the postprandial distress syndrome (PDS) variant. However, studies evaluating dietary modifications in PDS are sparse.

The investigators will perform a single-centre randomised trial evaluating traditional dietary advice (TDA) in PDS.

50 patients with PDS will be randomly assigned to a leaflet explaining reassurance-alone +/- TDA. The reassurance-alone group will be informed of the absence of organic disease and provided a diagnostic explanation of functional dyspepsia. The TDA group will receive the same information but also be recommended to eat smaller, regular meals and reduce the intake of caffeine/alcohol/fizzy drinks, fatty/processed/spicy foods, and fibre.

Questionnaires are to be completed during the 4-week trial, including self-reported adequate relief of dyspeptic symptoms, and the validated Leuven Postprandial Distress Scale (LPDS), Gastrointestinal Symptom Rating Scale, and Napean Dyspepsia Quality of Life Index.

The primary endpoint(s) to define clinical response will be evaluated over weeks 3-4 as, i) ≥50% adequate relief of dyspeptic symptoms, and ii) \>0.5-point reduction in the PDS subscale of the LPDS (calculated as the mean scores for early satiety, postprandial fullness, and upper abdominal bloating).

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
50
Inclusion Criteria
  • Fulfil Rome IV symptoms criteria for functional dyspepsia
  • Normal upper gastrointestinal endoscopy within last 3 years
  • Online access
  • English literate
Exclusion Criteria
  • Organic gastrointestinal diseases (e.g. inflammatory bowel disease, GI cancer, coeliac disease)
  • Major abdominal surgery (except laparoscopy, appendectomy, cholecystectomy)
  • Documented H.pylori in the last 3 months
  • History of eating disorders
  • Body mass index <20
  • Current use of opioids or anti-inflammatory drugs
  • Severe systemic disease (e.g. cardiac, renal, respiratory) necessitating frequent medical consultations
  • Pregnant
  • Diabetes mellitus
  • Scleroderma
  • Memory impairment
  • Current dietary interventions

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Traditional Dietary AdviceTraditional dietary advice-
Reassurance-aloneReassurance-alone-
Primary Outcome Measures
NameTimeMethod
Proportion of clinical responders between traditional dietary advice vs. reassurance alone based on the leuven postprandial distress scale (LPDS)4 weeks

The Leuven Postprandial Distress Scale (LPDS) assesses the severity of 8 upper gastrointestinal symptoms scored from 0 (none) to 4 (very severe). A difference of 0.7 from baseline for the cardinal PDS symptoms (average of first 3 questions) will be used as a cut-off to determine clinical response by comparing averaged pre-treatment scores with the average score during the weeks 3-4.

Proportion of clinical responders between traditional dietary advice vs. reassurance alone4 weeks

Self-reported adequate relief of dyspeptic symptoms as a binary answer (yes or no). A responder will be defined if ≥50% adequate relief of dyspeptic symptoms during weeks 3-4

Secondary Outcome Measures
NameTimeMethod
Changes in Gastrointestinal Symptom Rating Irritable Bowel syndrome Scale4 weeks

The validated Gastrointestinal Symptom Rating Scale assesses the symptoms of irritable bowel syndrome, depicting problems with satiety, abdominal pain, diarrhoea, constipation and bloating. Higher scores represent greater symptom severity. Change in monthly scores will be compared within- and between-treatments for both cohorts combined.

Changes in Hospital Anxiety and Depression scale4 weeks

The Hospital Anxiety and Depression Scale is a validated questionnaire assessing mood, with higher scores representing worse mood. Change in monthly scores will be compared within- and between-treatments for both cohorts combined.

Changes in Somatic Symptom reporting4 weeks

The validated patient health questionnaire-12 assess extra-intestinal somatic symptoms, with higher scores representing greater somatic symptom severity. Change in monthly scores will be compared within- and between-treatments for both cohorts combined.

Changes in Napean Dyspepsia-related Quality of Life Index4 weeks

The Napean Dyspepsia Scale is a validated questionnaire assessing dyspepsia-related quality of life syndrome, with higher scores representing worse quality of life. Change in monthly scores will be compared within- and between-treatments for both cohorts combined.

Trial Locations

Locations (1)

Royal Hallamshire Hospital

🇬🇧

Sheffield, South Yorkshire, United Kingdom

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