- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02526849
Efficacy and Safety of Fecal Microbiota Transplantation for Slow Transit Constipation
A Randomized Controlled Study of Efficacy, Safety and Durability of Fecal Microbiota Transplantation in Adult Patients With Slow Transit Constipation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Constipation is a chronic disease estimated to affect about 10% - 15% of the worldwide general population. Constipation frequency appears to augment with increasing age, particularly after 65 years old.
Recent evidence in the literature and collected in the investigators' laboratory confirm that constipation can be a consequence of intestinal dysbiosis, with an increase of potentially pathogenic microorganisms and a decrease of potentially beneficial microorganisms. These alterations may affect the motility and metabolic environment of colon, especially the production of short chain fatty acids (SCFAs).
A new and under-explored method to manipulate the gastrointestinal microbiota involves fecal microbiota transplantation (FMT). There has been growing interest in the use of fecal microbiota for the treatment of patients with chronic gastrointestinal infections (e.g. CDI) and other extraintestinal conditions (e.g. IBD). Similarly, the investigators suppose that reshaping the gut microbiome with FMT would be effective for patients with slow transit constipation.
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Jiangsu
-
Nanjing, Jiangsu, China, 210002
- Recruiting
- Department of Generay Surgery, Jinling hosptal, Medical School of Nanjing University
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Chronic constipation according to Rome III criteria, defined as two or fewer spontaneous, complete bowel movements (SCBMs) per week for a minimum of 6 months;
- Age ≥ 18 years;
- BMI: 18.5-25 kg/m2;
- Slow colonic transit confirmed by colonic transit test (colonic transit time (CTT) > 48 hours);
- Normal anorectal manometry, with no evidence of dyssynergia and confirmed ability to expel rectal balloon;
- No radiographic evidence of functional (i.e. pelvic floor dyssynergia) or anatomical (i.e. significant rectocele and intussusception) impediment to the expulsion of the radio-opaque contrast;
- Disease duration > 1 year;
- Traditional treatment with dietary modification, laxatives (including osmotic and stimulant laxatives), and biofeedback tried over the past 6 months without success;
Exclusion Criteria:
- Bowel constipation due to innate factor (i.e. megacolon) or secondary interventions (i.e. drugs, endocrine, metabolic, neurologic or psychologic disorders);
- History or evidence of gastrointestinal diseases (i.e. obstruction, cancer, inflammatory bowel diseases) ;
- Previous abdominal surgery, except cholecystectomy, appendicectomy, tubal ligation and cesarean section;
- Previous proctological or perianal surgery;
- A constipation condition meeting the Rome III criteria for IBS or functional abdominal pain syndrome;
- Pregnant or breast-feeding women;
- Infection with enteric pathogen;
- Usage of probiotics, prebiotics and/or synbiotics within the last month;
- Usage of antibiotics and/or PPIs within the last 3 months;
- Smoking or alcohol addiction within the last 3 months;
- Uncontrolled hepatic, renal, cardiovascular, respiratory or psychiatric disease;
- Disease or therapy with drugs (i.e. antidepressants, opioid narcotic analgesics, anticholinergics, calcium antagonists, nitrates, antimuscarinics) that, in the opinion of the investigator, could affect intestinal transit and microbiota.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fecal microbiota transplantation (FMT)
On day 1-6, patients received 100ml fresh FMT by nasointestinal tube, once per day.
The nasointestinal tube was placed in the patient's proximal jejunum through endoscopy.
Then, donor fecal microbiota was infused within 5 minutes through nasointestinal tube.
|
Standardized Frozen Fecal Microbiota will be infused via nasointestinal tube.
Other Names:
Conventional treatment was taken by both of two groups.
If patients did not have a bowel movement for 3 or more consecutive days, they were permitted to take up to 20 g of Macrogol 4000 powder (Forlax®, Ipsen, Paris, France).
If ineffective, an enema could be used.
|
Experimental: Conventional treatment
Conventional treatment was taken by both of two groups.
If patients did not have a bowel movement for 3 or more consecutive days, they were permitted to take up to 20 g of Macrogol 4000 powder (Forlax®, Ipsen, Paris, France).
If ineffective, an enema could be used.
|
Standardized Frozen Fecal Microbiota will be infused via nasointestinal tube.
Other Names:
Conventional treatment was taken by both of two groups.
If patients did not have a bowel movement for 3 or more consecutive days, they were permitted to take up to 20 g of Macrogol 4000 powder (Forlax®, Ipsen, Paris, France).
If ineffective, an enema could be used.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of patients having on average three or more SCBMs/week
Time Frame: 3 months
|
Proportion of patients having on average three or more spontaneous, complete bowel movements (SCBMs) per week was evaluated at week 4 and 12.
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean number of bowel movements per week
Time Frame: 3 months
|
Patients kept daily diaries about times of bowel movements each day.
|
3 months
|
Characteristics of bowel movements
Time Frame: 3 months
|
Patients kept daily diaries about stool consistency and degree of straining severity during defecation.
|
3 months
|
Constipation-related symptoms assessments
Time Frame: 3 months
|
Constipation-related symptoms were evaluated using the validated Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire at week 4 and 12.
|
3 months
|
Quality-of-Life assessments
Time Frame: 3 months
|
Quality-of-Life was evaluated using the validated Patient Assessment of Constipation Quality of Life (PAC-QOL) self-report questionnaire at week 4 and 12.
|
3 months
|
Colonic transit time measurements
Time Frame: 3 months
|
Colonic transit time (CTT) was measured at week 4 and 12 with the Metcalf method.
|
3 months
|
Usage of laxatives or enemas as rescue medication
Time Frame: 3 months
|
If patients did not have a bowel movement for 3 or more consecutive days, they were permitted to take up to 20 g of Macrogol 4000 powder (Forlax).
If ineffective, enema was used.
Patients kept daily diaries about the rescue medication when used.
|
3 months
|
Adverse events
Time Frame: 3 months
|
Adverse events include fever, diarrhea, abdominal pain, increased bloating, borborygmi, flatulence, nausea, vomiting, nasopharyngitis, and any other disorders.
|
3 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- RCT-FMT-STC-2015
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.
Clinical Trials on Slow Transit Constipation
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Jinling Hospital, ChinaUnknownSlow Transit ConstipationChina
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Jinling Hospital, ChinaUnknownSlow Transit ConstipationChina
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Jinling Hospital, ChinaCompleted
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Jinling Hospital, ChinaUnknownSlow Transit ConstipationChina
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Jinling Hospital, ChinaUnknownSlow Transit ConstipationChina
-
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-
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University of British ColumbiaCompleted
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Tsumura USACato ResearchCompletedFunctional Constipation | Gastric Emptying | Colonic Transit | Whole Gut Transit | Small Bowel Transit | Rectal Compliance | Rectal SensationUnited States
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