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Fermented Foods and Bowel Health in SCI

5 de junho de 2026 atualizado por: Jia Li, Ohio State University

High Fermented Food Intake to Improve Gut Microbiome and Bowel Dysfunction in Individuals With SCI

The goal of this clinical trial is to learn whether consuming a high fermented food diet improves bowel function and gut health in adults with chronic spinal cord injury (SCI). The study will also evaluate the feasibility and tolerability of consuming fermented foods daily for 10 weeks. The main questions it aims to answer are:

  1. Does a high fermented food diet improve neurogenic bowel dysfunction symptoms and colonic transit in adults with SCI?
  2. Does fermented food intake change gut microbiome composition, short-chain fatty acid production, and intestinal inflammation?

Researchers will compare a high fermented food diet to a control diet to evaluate effects on bowel health and gut microbiome outcomes.

Participants will:

  • Consume study foods daily for 10 weeks
  • Attend 2 in-person study visits
  • Collect stool samples at home and ship them overnight to the research team using provided collection kits and prepaid shipping materials
  • Complete bowel health questionnaires and dietary recalls
  • Undergo Sitz marker testing with abdominal X-rays to assess colonic transit
  • Participate in biweekly monitoring contacts throughout the study period

Visão geral do estudo

Status

Ainda não está recrutando

Tipo de estudo

Intervencional

Inscrição (Estimado)

44

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

    • Ohio
      • Columbus, Ohio, Estados Unidos, 43210
        • Ohio State University
        • Contato:

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto
  • Adulto mais velho

Aceita Voluntários Saudáveis

Não

Descrição

Inclusion Criteria:

  • Adults aged 18-70 years
  • At least 1 year post-onset of spinal cord injury, consistent with chronic spinal cord injury
  • Traumatic spinal cord injury involving cervical or thoracic levels
  • American Spinal Injury Association Impairment Scale classification A-D
  • Medically stable, with no recent hospitalizations or acute illnesses
  • Able to safely consume study foods, including fermented and control food products
  • Experiencing neurogenic bowel dysfunction, defined by at least one of the following:

    1. Three or fewer bowel movements per week
    2. More than 60 minutes required per bowel care routine
    3. Symptoms of incomplete evacuation
    4. Abdominal distension
    5. Fecal incontinence
  • Established and stable bowel program, defined as a consistent individualized routine of timing, frequency, and evacuation methods that has remained unchanged for at least 4 weeks before enrollment

Exclusion Criteria:

  • Antibiotic use within the past 4 weeks
  • Active gastrointestinal disease, including Crohn's disease, ulcerative colitis, celiac disease, or gastrointestinal obstruction
  • Current intake of probiotics or fermented foods exceeding 3 servings per day
  • Pregnancy or breastfeeding
  • Recent major bowel surgery within the past 12 weeks
  • Unresolved fecal impaction
  • Unstable bowel regimen that could interfere with accurate motility assessment
  • Inability to safely undergo Sitz marker testing, including any of the following:

    1. Inability to swallow the capsule
    2. Pregnancy, due to radiation exposure
    3. Contraindication to abdominal X-ray procedures

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Dobro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Fermented Food Arm
Fermented food arm: participants randomized to the fermented foods arm will consume ≥6 servings/day of fermented foods after a graded ramp-up to minimize intolerance. A 3-week ramp-up (weeks 1-3) will increase intake from 2 to 6 servings/day, followed by a 7-week full-intake phase (weeks 4-10). To avoid single-food dominance and improve microbiome diversity, participants will be required to consume ≥3 categories/day (e.g., vegetables, dairy, soy, tea, brine) and rotate through all core fermented food categories and consume a variety of items across a 2-3-day period. This will ensure all core items are consumed throughout the week. Core food items will be delivered biweekly.
Participants randomized to the fermented foods arm will consume ≥6 servings/day of fermented foods after a graded ramp-up to minimize intolerance.
Colonic transit time will be assessed using the Sitz marker test, a standardized radiopaque marker method for evaluating bowel motility. Participants will swallow a capsule containing radiopaque markers, and abdominal X-rays will be obtained on day 5 to determine the number and distribution of retained markers throughout the colon. Greater marker retention indicates slower colonic transit, whereas fewer retained markers indicate faster transit and improved bowel motility.
Comparador de Placebo: Control Diet Arm
Participants randomized to the control arm will receive non-fermented versions of the base foods consumed by the fermented foods arm and will be instructed to avoid fermented foods during the trial.
Colonic transit time will be assessed using the Sitz marker test, a standardized radiopaque marker method for evaluating bowel motility. Participants will swallow a capsule containing radiopaque markers, and abdominal X-rays will be obtained on day 5 to determine the number and distribution of retained markers throughout the colon. Greater marker retention indicates slower colonic transit, whereas fewer retained markers indicate faster transit and improved bowel motility.
Participants randomized to the control arm will receive non-fermented versions of the base foods consumed by the fermented food arm and will be instructed to avoid fermented foods during the trial.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Fecal microbiome composition assessed by shotgun metagenomic sequencing
Prazo: Baseline, weeks 5 and 10
Stool samples will be analyzed using shotgun metagenomic sequencing to characterize gut microbial taxonomic composition. Outcomes may include relative abundance of bacterial taxa and alpha/beta diversity metrics.
Baseline, weeks 5 and 10
Gut microbiome functional potential measured by shotgun metagenomic sequencing
Prazo: Baseline, week 5, and week 10
Shotgun metagenomic sequencing data will be used to assess microbial functional potential, including gene family, KEGG Ortholog, and metabolic pathway/module abundance.
Baseline, week 5, and week 10
Fecal calprotectin measured by ELISA
Prazo: Baseline, weeks 5 and 10
Fecal calprotectin concentration will be measured in stool samples using an ELISA assay. Results will be reported as fecal calprotectin concentration, with higher values indicating greater intestinal inflammation.
Baseline, weeks 5 and 10
Fecal Short Chain Fatty Acid measured by LC-MS/MS
Prazo: Baseline, weeks 5 and 10
Concentrations of fecal short-chain fatty acids, including acetate, propionate, butyrate, and branched-chain fatty acids, will be quantified using LC-MS/MS. Results will be reported as fecal SCFA concentrations.
Baseline, weeks 5 and 10

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Neurogenic bowel dysfunction measured by the Neurogenic Bowel Dysfunction Score
Prazo: Baseline, weeks 5 and 10
Neurogenic bowel dysfunction will be assessed using the Neurogenic Bowel Dysfunction Score. Total scores range from 0 to 47, with higher scores indicating more severe bowel dysfunction.
Baseline, weeks 5 and 10
Colonic transit measured by the Sitz marker test
Prazo: Baseline, week 10
Colonic transit will be assessed using the Sitz marker test. Participants will ingest a capsule containing radiopaque markers, and abdominal X-rays will be used to quantify the number and distribution of retained markers. Greater marker retention indicates slower colonic transit.
Baseline, week 10
Constipation severity measured by the Constipation Severity Instrument
Prazo: Baseline, weeks 5 and 10
Constipation severity will be assessed using the Constipation Severity Instrument (CSI), a 16-item questionnaire with total scores ranging from 0 to 73, where higher scores indicate greater constipation severity.
Baseline, weeks 5 and 10
Stool consistency measured by the Bristol Stool Form Scale
Prazo: Baseline, weeks 5 and 10
Stool consistency will be assessed using the Bristol Stool Form Scale, a 7-point scale ranging from Type 1, separate hard lumps, to Type 7, entirely liquid stool. Types 3-4 generally reflect more normal stool form.
Baseline, weeks 5 and 10

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Estimado)

1 de agosto de 2026

Conclusão Primária (Estimado)

31 de julho de 2029

Conclusão do estudo (Estimado)

31 de julho de 2029

Datas de inscrição no estudo

Enviado pela primeira vez

27 de maio de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

5 de junho de 2026

Primeira postagem (Real)

10 de junho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

10 de junho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

5 de junho de 2026

Última verificação

1 de junho de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

SIM

Descrição do plano IPD

De-identified individual participant data (IPD) underlying published results, including clinical, dietary, bowel function, metabolomic, and microbiome-derived datasets, will be shared within 12 months of primary publication or study completion, whichever occurs first. Processed clinical and omics datasets will be shared through the Open Data Commons for Spinal Cord Injury (ODC-SCI) and Vivli.

Prazo de Compartilhamento de IPD

Data will be available beginning 12 months after publication of the primary study results or 12 months after study completion, whichever occurs first, and will remain available indefinitely.

Critérios de acesso de compartilhamento IPD

De-identified data will be available to qualified investigators for scientifically sound research purposes. Requests will be reviewed by the study investigators and/or repository governance committees. Data will be provided under applicable data use agreements and in accordance with institutional and federal human subjects protections.

Tipo de informação de suporte de compartilhamento de IPD

  • PROTOCOLO DE ESTUDO
  • SEIVA

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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Ensaios clínicos em Lesão da medula espinal

Ensaios clínicos em fermented foods

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