Abdominal Symptom Phenotype Study in Children (ASPPNB)

February 4, 2013 updated by: Robert Shulman, M.D., Baylor College of Medicine

Abdominal Symptom Phenotype: Pathways to New Biomarkers

Children and adults commonly suffer from recurrent abdominal (stomach) pain. One type is called irritable bowel syndrome (IBS). IBS in adults and children is one of the most common and costly health care problems in the US. Some children have pain frequently (recurrent pain) while others rarely have pain. The investigators are conducting this study to help us answer questions about the causes and treatments, and management of IBS in children.

The purpose of this study is to find out if there is more than one type of IBS in children. If there is, this will be important in deciding the best treatments. The investigators also want to learn how children with IBS differ from those who do not have recurrent abdominal (stomach) pain.

Study Overview

Status

Completed

Conditions

Detailed Description

Functional gastrointestinal (GI) disorders (FGIDs), in particular irritable bowel syndrome (IBS) in adults and children, are among the most common and costly health care problems in the US. IBS disproportionately affects adult women (10-15% in western nations) and adolescent girls. Yet, health care providers remain challenged to provide effective clinical management. The etiology of IBS is not well defined and likely multi-factorial.

A Need to Define Subgroups of IBS:

This study emerges from the claim that identification of patient subgroups will advance our understanding of IBS and ultimately help develop treatment approaches. Most studies have lumped together patients with IBS into 2 groups (constipation-, diarrhea-predominant) and tested whether they differ from healthy controls. We propose that a paradigm shift is in order. We should recognize that IBS likely has multiple causes and therefore, multiple expressions. We speculate that by understanding better defined patient subgroups and linking them to newer biomarkers or tests, ultimately will further the understanding of the origins and create effective treatments.

Study Type

Observational

Enrollment (Actual)

45

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Texas
      • Houston, Texas, United States, 77030
        • Texas Children's Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

7 years to 12 years (Child)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

We are studying only girls in this exploratory study because IBS is more common in girls than boys and the results of these studies can be compared with the results from studies of IBS in adults where the overwhelming number of patients are women.

Girls who meet the Rome III criteria for IBS or healthy girls with no complaints of stomach pain.

Description

Inclusion Criteria:

IBS:

  • Age 7-12 years
  • Females
  • Meet criteria for irritable bowel syndrome without evidence of organic disease
  • Developmentally normal
  • English speaking (as the psychological measures are either not available or validated in Spanish)
  • No other chronic, significant (e.g., diabetes, migraines) medical conditions
  • No menses

Controls:

  • Age 7-12 years
  • Females
  • No abdominal pain
  • No GI or chronic medical conditions (e.g., diabetes)
  • Developmentally normal
  • English speaking (as the psychological measures are not available or validated in Spanish)
  • No menses

Exclusion Criteria:

  • Non-english speaking
  • Developmentally or cognitively impaired
  • Males
  • Menses
  • No mother in the household for administration of the psychological measures
  • Use of any anti-depressants
  • History of migraines or chronic pain disorders
  • On narcotics for at least 1 week prior to enrollment
  • On any NSAIDs or pain reliever for at least 24 hours prior to enrollment
  • Sought psychotherapy in past 6 months for abdominal pain

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Girls with IBS
Girls ages 7-12 years who meet Rome III criteria for IBS
Healthy Girls (controls)
Girls ages 7-12 years who are otherwise healthy and have no complaints of stomach pain

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Compare biomarkers (tests) on girls with and without IBS
Time Frame: Two Days
Biomarkers: Proteomic analysis of urine samples; Results of video capsule endoscopy (VCE) using the PillCam; Serum lymphocyte activation and cytokine levels (IL-8, IL-10 and IL-12) Responses to DNIC procedure;
Two Days
Compare the response of stress in girls with and without IBS
Time Frame: One Day
Salivary cortisol levels prior to and after the diffuse noxious inhibitory control (DNIC) procedure; Psychological characteristics of the child and mother
One Day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Baylor College of Medicine

Collaborators

National Institute of Nursing Research (NINR)
University of Washington

Investigators

  • Principal Investigator: Robert J Shulman, M.D., Baylor College of Medicine - Texas Children's Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2010

Primary Completion (Actual)

August 1, 2012

Study Completion (Actual)

August 1, 2012

Study Registration Dates

First Submitted

September 16, 2010

First Submitted That Met QC Criteria

September 16, 2010

First Posted (Estimate)

September 17, 2010

Study Record Updates

Last Update Posted (Estimate)

February 6, 2013

Last Update Submitted That Met QC Criteria

February 4, 2013

Last Verified

February 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 25755
  • RC2NR011959 (U.S. NIH Grant/Contract)

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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