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Trial registered on ANZCTR
Registration number
ACTRN12615000489594
Ethics application status
Approved
Date submitted
29/04/2015
Date registered
18/05/2015
Date last updated
10/02/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluation of the efficacy of oral enzymes for the treatment of carbohydrate intolerance in Irritable Bowel Syndrome.
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Scientific title
Evaluation of the efficacy of oral enzymes for the treatment of carbohydrate intolerance in Irritable Bowel Syndrome.
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Secondary ID [1]
286604
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Irritable Bowel Syndrome
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Condition category
Condition code
Diet and Nutrition
295161
295161
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0
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Other diet and nutrition disorders
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Oral and Gastrointestinal
295229
295229
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Breath hydrogen and symptoms will be measured on 3 different study arms. Each arm involves 3 days of consuming foods provided (low in FODMAPs but high in Galactooligosaccharides) plus an oral enzyme supplement. The food will be identical for each study arm. The food is low in FODMAPs meaning it does not contain foods classified as high FODMAP according to the Monash University low FODMAP diet with the exception of foods high in galactooligosaccharides. Types of foods high in galactooligosaccharides include nuts, legumes and lupin flakes which have been used in the study diet. The maximum total FODMAP content (mainly coming from the galactooligosaccharides) in the diet per day is 7g.
In between the study arms there will be at least a 3 day washout period.
Breath hydrogen will be measured hourly for 12 hours on the 2nd day of each study arm.
Symptoms will be measured once daily at bed time each day.
An oral enzyme supplement (alpha-galactosidase) in 2 doses or placebo will be given with each study arm. The supplement will be given three times daily (with each meal) for the 3 days of each study arm. The enzyme or placebo for each arm will be given in a random order to participants, but will include:
*Placebo will be 2 glucose tablets. I.e. no dose.
*Half dose will be 1 enzyme (containing 300 galU) and 1 glucose tablet.
*Full dose will be 2 enzyme tablets (containing total 600 galU).
Tablets will all look the same to aid in blinding.
Participants will be asked to return their tablet containers to assist in monitoring adherence.
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Intervention code [1]
291728
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Treatment: Other
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Comparator / control treatment
Placebo (glucose)
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Breath hydrogen - this will measure the amount of carbohydrate which is not absorbed in the small intestine.
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Assessment method [1]
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Timepoint [1]
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Day 2 of each study arm
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Secondary outcome [1]
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Gastrointestinal symptoms - these will be measured using a 100mm visual analogue scale as well as a 3 point likert scale.
Types of symptoms that will be measured include:
*Overall Symptoms
*Abdominal pain
*Abdominal bloating
*Wind
*Tiredness and lethargy
*Nausea
*Heartburn
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Assessment method [1]
314360
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Timepoint [1]
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Day 3 of each study arm
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Eligibility
Key inclusion criteria
People with Irritable Bowel Syndrome, as assessed by Rome III criteria, but otherwise well.
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Minimum age
18
Years
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Maximum age
70
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
*People with other diagnosed gastrointestinal disorders such as Coeliac Disease and IBD.
*Non-hydrogen producers as shown on Fructan breath hydrogen test.
*Women who are pregnant or breastfeeding.
*Those with known food allergy likely to affect ability to follow study dietary protocol.
*Those who have taken antibiotics, probiotics or prebiotics within the 4 weeks prior to the study.
*Colonoscopy (bowel prep) within the past 4 weeks.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
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Actual
30/04/2015
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Date of last participant enrolment
Anticipated
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Actual
30/04/2016
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Date of last data collection
Anticipated
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Actual
30/06/2016
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Sample size
Target
30
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Accrual to date
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Final
31
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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NHMRC
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Gastroenterology
Central Clinical School
Monash University
Level 6, The Alfred Centre
99 Commercial Road
Prahran VIC 3004
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
289854
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Monash University Human Research Ethics Committee
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Ethics committee address [1]
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Monash University, Vic 3800, Australia
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
292747
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Approval date [1]
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25/09/2013
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Ethics approval number [1]
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CF13/2060 - 2013001029
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Summary
Brief summary
Irritable bowel syndrome (IBS) is a common disorder affecting 5-15% of Australians. Recently the Gastroenterology department research team at Monash University have created a dietary management approached for the treatment of IBS. The dietary approach termed the low FODMAP diet restricts poorly absorbed carbohydrates. The term FODMAPs denotes fermentable, oligo-, di-, mono-saccharides and polyols. These carbohydrates are poorly absorbed in the small intestinal lumen and therefore travel to the large intestine where they are fermented by colonic bacteria to produce products of hydrogen, methane, carbon dioxide and short chain fatty acids. The dietary approach uses a restrictive phase followed by a re-introduction phase to assess individual tolerance to the various FODMAP subgroups. The dietary restrictions however can be difficult to maintain, especially among patients with other food intolerances or dislikes. This is particularly relevant to vegetarians and vegans as legumes, a major source of protein, is restricted during the low FODMAP diet. The types of carbohydrates in legumes are unable to be digested in the human small intestine as humans do not have the enzyme to break them down; they are therefore often a trigger of IBS symptoms. In the USA and Europe there are tablets on the market which contain alpha-galactosidase, an enzyme to break down the carbohydrate’s present in legumes. A few studies have been conducted to assess the enzyme use in healthy controls, but there is limited research using them in patients with IBS. The aim of this study is to evaluate if the alpha-galactosidase enzyme can reduce breath hydrogen and symptoms in IBS. We hypothesize that there will be a reduction in both hydrogen and symptoms with the use of the alpha-galactosidase enzyme.
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Trial website
http://www.med.monash.edu/cecs/gastro/clin-trials/index.html
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Jane Muir
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Address
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Department of Gastroenterology Central Clinical School Monash University
Level 6, The Alfred Centre 99 Commercial Road Prahran VIC 3004
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Country
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Australia
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Phone
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+61 3 9903-0274
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Caroline Tuck
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Address
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Department of Gastroenterology Central Clinical School Monash University
Level 6, The Alfred Centre 99 Commercial Road Prahran VIC 3004
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Country
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Australia
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Phone
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+61 3 9903-0264
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Caroline Tuck
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Address
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Department of Gastroenterology Central Clinical School Monash University
Level 6, The Alfred Centre 99 Commercial Road Prahran VIC 3004
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Country
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Australia
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Phone
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+61 3 9903-0264
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Fax
56840
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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