ConfocAl endomicroSCopy bAsed Diet Trial in IBS (CASCADE)
Targeted Elimination Diet in IBS Patients Following Identification of Trigger Nutrients Using Confocal Laser Endomicroscopy
After a thorough baseline evaluation, IBS patients will be exposed to nutrients while undergoing confocal laser endomicroscopy (CLE). Patients presenting an acute mucosal reaction upon nutrient exposure will be instructed to exclude their respective trigger nutrient or a nutrient without mucosal reaction (=sham diet) from their diet for 4 weeks in a randomized, blinded crossover fashion.
The aim of the trial is to assess the symptomatic response to the targeted diet and further elucidate mechanisms underlying the acute mucosal reactions observed in CLE upon nutrient exposure.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Lukas M Balsiger, MD
- Phone Number: +32 16 37 70 90
- Email: lukasmichaja.balsiger@kuleuven.be
Study Locations
-
-
-
Leuven, Belgium, 3000
- Recruiting
- UZ Leuven
-
Contact:
- Lukas M Balsiger, MD
- Phone Number: +32492447624
- Email: lukasmichaja.balsiger@kuleuven.be
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18-70 y/o (70 years included)
- Male or female subjects
- IBS-D and IBS-M (i.e. IBS-non-C) according to Rome IV criteria
- Moderate to severe symptom severity as defined by the Irritable bowel syndrome severity scoring system (IBS-SSS) (i.e. IBS-SSS >175 points)
- Provide written informed consent to participate in the study
- Women of child-bearing potential agree to apply a highly effective method of birth control during the entire duration of the trial. Highly effective birth control is defined as those which result in a low failure rate (i.e., less than 1% per year) when used constantly and correctly such as implants, injectables, combined oral contraceptive method, or some intrauterine devices (IUDs), sexual abstinence, or vasectomized partner. Women of non-childbearing potential may be included if surgically sterile (tubal ligation or hysterectomy) or postmenopausal with at least 2 year without spontaneous menses.
- Subjects who are capable to understand the study and the questionnaires, and to comply with the study requirements.
Exclusion Criteria:
- - Pregnant or breastfeeding women
- History of major surgery of the gastrointestinal tract (cholecystectomy and uncomplicated appendectomy are allowed)
- Symptoms predominantly associated with functional dyspepsia or gastro-esophageal reflux disease
- Immunoglobuline E (IgE)-mediated food allergies identified by immunocap blood tests or skin prick testing
- Known underlying organic gastrointestinal disease
- Current or recent use of NSAIDs, proton-pump inhibitors, systemic histamine-receptor antagonists, mast cell stabilizers, corticosteroids, opioids (need to be stopped at least 2 weeks). Use of antibiotics in the past 6 weeks.
- Allergy to Fluorescein, Xylocaine or Propofol
- Known celiac disease
- Following a diet interfering with the study diet in opinion of the investigator
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Real diet
Diet excluding the trigger nutrient identified by an acute mucosal reaction in CLE
|
Diet excluding either trigger and sham nutrient in a blinded crossover fashion (CLE positive individuals with identified trigger) or wheat and soy in a blinded crossover fashion (CLE negative individuals without identified trigger)
|
|
Sham Comparator: Sham diet
Diet excluding a sham nutrient without acute mucosal reaction in CLE
|
Diet excluding either trigger and sham nutrient in a blinded crossover fashion (CLE positive individuals with identified trigger) or wheat and soy in a blinded crossover fashion (CLE negative individuals without identified trigger)
|
|
Active Comparator: Wheat exclusion diet
In patients without identified trigger nutrient (i.e.
no acute mucosal reaction to any nutrient), wheat will be excluded as an empirical diet in crossover fashion with soy.
|
Diet excluding either trigger and sham nutrient in a blinded crossover fashion (CLE positive individuals with identified trigger) or wheat and soy in a blinded crossover fashion (CLE negative individuals without identified trigger)
|
|
Active Comparator: Soy exclusion diet
In patients without identified trigger nutrient (i.e.
no acute mucosal reaction to any nutrient), wheat will be excluded as an empirical diet in crossover fashion with soy.
|
Diet excluding either trigger and sham nutrient in a blinded crossover fashion (CLE positive individuals with identified trigger) or wheat and soy in a blinded crossover fashion (CLE negative individuals without identified trigger)
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Responder rates in targeted diet vs sham diet
Time Frame: After 4 weeks of dietary intervention
|
Response defined by an improvement of minimum 50 points in the IBS-SSS.
|
After 4 weeks of dietary intervention
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Baseline mucosal immune cell composition between groups
Time Frame: Baseline
|
Differences in baseline mucosal mast-cell and eosinophil counts between CLE positive and negative patients
|
Baseline
|
|
Baseline permeability measures between groups
Time Frame: At baseline
|
Differences in baseline permeability measures between CLE positive and negative patients and healthy volunteers using Ussing chambers
|
At baseline
|
|
Evolution of permeability measures between dietary interventions
Time Frame: Baseline and end of respective dietary intervention
|
Differences in permeability measures between dietary interventions (i.e.
verum, sham, wheat and soy) during the dietary interventions using urinary Lactulose/Mannitol/Sucralose ratio
|
Baseline and end of respective dietary intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- S65495
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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