Effects of a Prebiotic-Probiotic Combination on Constipation Symptoms and Quality of Life
Effects of a Prebiotic-Probiotic Combination on Gastrointestinal Symptoms and Quality of Life in Individuals With Constipation: A Randomized, Double-Blind, Controlled Trial
This study aims to evaluate whether a combination of a prebiotic (1-kestose) and a probiotic (Lacticaseibacillus rhamnosus BBH112) improves gastrointestinal symptoms and quality of life in adults with constipation-related symptoms.
A total of 40 adults aged 19 to 80 years will be enrolled in this randomized, double-blind, controlled trial. Participants will be randomly assigned to receive either the probiotic combined with the prebiotic or the probiotic combined with a placebo for 8 weeks.
The primary objective is to compare overall satisfaction with gastrointestinal symptom improvement between the two groups after 8 weeks. The study will also assess changes in abdominal pain, bloating, bowel habits, stool consistency, quality of life, and psychological well-being. In addition, changes in the gut microbiome will be evaluated using stool samples collected before and after the intervention.
The findings may help determine whether adding a prebiotic to probiotic supplementation provides additional benefits for adults experiencing constipation-related gastrointestinal symptoms.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Constipation and related gastrointestinal symptoms, including abdominal pain, bloating, and abdominal discomfort, are common complaints that can substantially impair quality of life. Alterations in the gut microbiome have been suggested to contribute to gastrointestinal symptoms through their effects on intestinal motility, visceral sensitivity, and gut-brain interactions. Probiotics and prebiotics have been investigated as potential interventions for improving gastrointestinal symptoms by modulating the gut microbiome.
Lacticaseibacillus rhamnosus BBH112 is a probiotic strain isolated from a healthy human donor. 1-Kestose (GF2) is a prebiotic fructooligosaccharide that may promote the growth and activity of beneficial intestinal bacteria. The combination of these two components may provide additional benefits compared with probiotic supplementation alone.
This prospective, randomized, double-blind, controlled trial aims to evaluate the efficacy and safety of combined prebiotic and probiotic supplementation in adults with constipation-related gastrointestinal symptoms.
A total of 40 participants aged 19 to 80 years will be enrolled at Seoul National University Bundang Hospital, Republic of Korea. Eligible participants will be randomly assigned in a 1:1 ratio to one of two groups:
Experimental group: Lacticaseibacillus rhamnosus BBH112 (two capsules once daily) combined with 1-kestose (5 g twice daily).
Control group: Lacticaseibacillus rhamnosus BBH112 (two capsules once daily) combined with placebo powder (5 g twice daily).
Both groups will receive the assigned supplementation for 8 weeks. Participants and investigators will remain blinded to group allocation.
The primary outcome is the between-group difference in overall satisfaction with gastrointestinal symptom improvement at week 8.
Secondary outcomes include changes in gastrointestinal symptom severity, assessed using the Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) and symptom-based questionnaires; quality of life, assessed using the IBS Quality of Life questionnaire (IBS-QoL); bowel movement frequency and stool consistency, assessed using bowel habit questionnaires and the Bristol Stool Form Scale (BSFS); and psychological well-being, assessed using the Hospital Anxiety and Depression Scale (HADS). Clinical outcomes will be evaluated at baseline, week 4, and week 8.
Stool samples will be collected at baseline and week 8 to evaluate changes in gut microbiome composition and diversity. The study will also explore associations between microbiome changes and improvements in gastrointestinal symptoms.
Safety will be assessed through monitoring of adverse events during the study period.
This study is expected to provide preliminary clinical evidence regarding the potential additional benefits of combining a prebiotic with probiotic supplementation for constipation-related gastrointestinal symptoms and associated changes in the gut microbiome.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
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Gyeonggi-do
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Seongnam-si, Gyeonggi-do, Sydkorea, 13620
- Rekruttering
- Seoul National University Bundang Hospital
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Kontakt:
- Ho-Kyoung Lee
- Telefonnummer: +82-10-3552-3177
- E-mail: hokyung0327@naver.com
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Kontakt:
- Cheol Min Shin
- Telefonnummer: +82-31-787-7009
- E-mail: scm6md@gmail.com
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Ledende efterforsker:
- Cheol Min Shin
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
**Inclusion Criteria:**
- Korean men and women aged 19 to 80 years.
- Adults experiencing constipation-related lower gastrointestinal symptoms, including abdominal pain or bloating, along with constipation symptoms such as excessive straining during defecation, hard stools (Bristol Stool Form Scale types 1-2), or fewer than three bowel movements per week.
- No diagnosed organic gastrointestinal disease.
- Colonoscopy performed within the previous 5 years, or at enrollment, confirming the absence of significant organic colonic disease. Colonoscopy reports from other institutions are acceptable. Individuals who underwent biopsy or polypectomy may be enrolled if the investigator determines that participation is appropriate after reviewing the results.
- Women who are surgically sterile or women of childbearing potential with a negative urine or serum pregnancy test who agree to use appropriate contraception during the study. Appropriate contraceptive methods include oral contraceptives, intrauterine devices, double-barrier methods, or hormonal implants. Male participants must also agree to appropriate contraceptive measures during the study.
- Individuals capable of understanding the study and communicating their decisions clearly, without significant uncontrolled neurological or psychiatric conditions. Individuals with adequately controlled neurological or psychiatric disorders may participate.
- Individuals who voluntarily provide written informed consent to participate in the study.
**Exclusion Criteria:**
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Pregnant or breastfeeding women.
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Individuals whose predominant gastrointestinal symptom is diarrhea.
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Participation in another investigational drug trial within 3 months before Visit 1. Individual cases may be reviewed in consultation with the study monitor.
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Any condition or circumstance that, in the investigator's judgment, may increase the risks associated with study participation or interfere with the conduct of the study.
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Severe congestive heart failure or severe angina pectoris.
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Diagnosed lactose intolerance or immunosuppression.
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Current use of medications that may affect the study intervention or outcomes, including gastrointestinal medications, probiotics, intestinal regulators, or antibiotics, unless the following conditions are met:
- Probiotic use may be discontinued at least 2 weeks before enrollment.
- Antibiotics or gastrointestinal medications, including potassium-competitive acid blockers, proton pump inhibitors, histamine-2 receptor antagonists, pinaverium, or trimebutine, may be discontinued at least 4 weeks before enrollment.
- Participants requiring continued gastrointestinal medications may be eligible if the type and dosage of these medications remain unchanged throughout the study period.
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Uncontrolled hypertension, defined as systolic blood pressure greater than 160 mmHg or diastolic blood pressure greater than 100 mmHg at Visit 1, regardless of antihypertensive treatment.
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Uncontrolled endocrine disorders (including diabetes mellitus), metabolic disorders (such as secondary hyperlipidemia), or hypothyroidism. Participants with a history of hypothyroidism may be eligible if they have received stable thyroid hormone replacement therapy for at least 4 weeks before the study visit and have a thyroid-stimulating hormone (TSH) level within the normal reference range at Visit 2.
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Impaired renal function, defined as serum creatinine greater than 2.0 mg/dL at Visit 1, or the presence of nephrotic syndrome.
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Diagnosis of malignancy within the previous 5 years, except for individuals considered cured.
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Significant psychiatric instability or psychiatric disorders that are not adequately controlled with medication or psychiatric treatment.
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Use of systemic corticosteroids within 1 month before Visit 1.
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History of abdominal surgery other than appendectomy, cesarean section, hysterectomy, or hernia surgery. Individuals with other abdominal surgical histories may be enrolled if the investigator determines that participation is appropriate.
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Any other condition that, in the investigator's judgment, makes the individual unsuitable for participation in the study.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Probiotic (L.rhamnosus BBH112) Plus Prebiotic (1-Kestose)
Participants in the experimental group will receive Lacticaseibacillus rhamnosus BBH112 (two capsules orally once daily) in combination with the prebiotic 1-kestose (GF2, 5 g orally twice daily) for 8 weeks. This group will be evaluated to determine whether the addition of 1-kestose to probiotic supplementation improves constipation-related gastrointestinal symptoms, bowel habits, and quality of life. |
Lacticaseibacillus rhamnosus BBH112 is a probiotic strain isolated from a healthy human donor. The probiotic is administered orally as two capsules once daily for 8 weeks. Each capsule contains 1 × 10^10 colony-forming units (CFU) of L. rhamnosus BBH112, providing a total daily dose of 2 × 10^10 CFU. Participants in both the experimental and active comparator groups will receive this probiotic supplementation. 1-Kestose (GF2) is a prebiotic fructooligosaccharide with a purity of at least 98%. Participants assigned to the experimental group will receive 1-kestose powder orally at a dose of 5 g twice daily (total daily dose of 10 g) for 8 weeks, in combination with Lacticaseibacillus rhamnosus BBH112. The intervention aims to evaluate the additional effects of prebiotic supplementation on constipation-related gastrointestinal symptoms, bowel habits, quality of life, and gut microbiome composition.
Andre navne:
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Aktiv komparator: Probiotic (L.rhamnosus BBH112) Plus Placebo
Participants in the active comparator group will receive Lacticaseibacillus rhamnosus BBH112 (two capsules orally once daily) in combination with placebo powder (dextrin, 5 g orally twice daily) for 8 weeks. This group will serve as the comparator to assess the additional effects of 1-kestose supplementation beyond probiotic administration alone on constipation-related gastrointestinal symptoms, bowel habits, and quality of life. |
Lacticaseibacillus rhamnosus BBH112 is a probiotic strain isolated from a healthy human donor. The probiotic is administered orally as two capsules once daily for 8 weeks. Each capsule contains 1 × 10^10 colony-forming units (CFU) of L. rhamnosus BBH112, providing a total daily dose of 2 × 10^10 CFU. Participants in both the experimental and active comparator groups will receive this probiotic supplementation. Participants assigned to the active comparator group will receive placebo powder orally at a dose of 5 g twice daily (total daily dose of 10 g) for 8 weeks, in combination with Lacticaseibacillus rhamnosus BBH112. The placebo will be administered under blinded conditions to allow comparison with the prebiotic intervention. |
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Proportion of Participants Satisfied With Overall Gastrointestinal Symptom Improvement
Tidsramme: Week 8
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Overall satisfaction with gastrointestinal symptom improvement will be assessed at week 8 using a participant-reported assessment of symptom improvement following supplementation. The outcome will be compared between the group receiving Lacticaseibacillus rhamnosus BBH112 plus 1-kestose and the group receiving BBH112 plus placebo powder. |
Week 8
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
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Change in Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS)
Tidsramme: Baseline, Week 4, and Week 8
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Changes in gastrointestinal symptom severity will be assessed using the Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS). The total score ranges from 0 to 500, with higher scores indicating greater symptom severity. Changes from baseline to weeks 4 and 8 will be compared between the two treatment groups. |
Baseline, Week 4, and Week 8
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Change in Irritable Bowel Syndrome Quality of Life (IBS-QoL) Score
Tidsramme: Baseline, Week 4, and Week 8
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Changes in disease-related quality of life will be evaluated using the Irritable Bowel Syndrome Quality of Life (IBS-QoL) questionnaire. The transformed total score ranges from 0 to 100, with higher scores indicating better quality of life. Changes from baseline to weeks 4 and 8 will be compared between the two treatment groups. |
Baseline, Week 4, and Week 8
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Change in Gastrointestinal Symptom Severity Scores
Tidsramme: Baseline, Week 4, and Week 8
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Changes in individual gastrointestinal symptoms, including abdominal pain, abdominal discomfort, bloating, constipation, and diarrhea-related symptoms, will be evaluated using symptom-based questionnaires derived from the Rome IV assessment. Symptom severity will be rated on a scale from 0 to 10, with higher scores indicating more severe symptoms. Changes from baseline to weeks 4 and 8 will be compared between groups. |
Baseline, Week 4, and Week 8
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Change in Stool Consistency Assessed by the Bristol Stool Form Scale (BSFS)
Tidsramme: Baseline, Week 4, and Week 8
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Changes in stool consistency will be assessed using the Bristol Stool Form Scale (BSFS), which classifies stool form into seven types (1-7), ranging from separate hard lumps to entirely liquid stools. Changes in mean BSFS scores from baseline to weeks 4 and 8 will be compared between the two treatment groups. |
Baseline, Week 4, and Week 8
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Change in Hospital Anxiety and Depression Scale (HADS) Scores
Tidsramme: Baseline, Week 4, and Week 8
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Changes in anxiety and depressive symptoms will be assessed using the Hospital Anxiety and Depression Scale (HADS). The questionnaire consists of two subscales, HADS-Anxiety (HADS-A) and HADS-Depression (HADS-D), each ranging from 0 to 21, with higher scores indicating more severe symptoms. Changes in subscale scores from baseline to weeks 4 and 8 will be compared between groups. |
Baseline, Week 4, and Week 8
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Change in Gut Microbiome Diversity and Composition
Tidsramme: Baseline and Week 8
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Changes in fecal gut microbiome diversity and composition will be evaluated using 16S rRNA gene sequencing of stool samples collected at baseline and week 8. Alpha diversity will be assessed using the Shannon diversity index and observed features, while beta diversity will be evaluated using Bray-Curtis dissimilarity and weighted and unweighted UniFrac distances. Changes in microbial diversity and composition will be compared between the two treatment groups. |
Baseline and Week 8
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- B-2604-1036-002
- 2024ER211402 (Andet bevillings-/finansieringsnummer: National Institute of Health, Korea)
Plan for individuelle deltagerdata (IPD)
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