Dietary Treatment of Endometriosis-related Irritable Bowel Syndrome

NCT02924493 | Completed

• 1 other identifier: Diet-in-endometriosis
• Study Type: interventional
• Target: 22
• Locations: 1 country
• Sites: 1

Brief Summary

Many patients with endometriosis experience extra genital and abdominal symptoms as a major part of their problem. This includes gastrointestinal dysfunction with pain, urinary symptoms compatible with interstitial cystitis and gastrointestinal symptoms resembling the irritable bowel syndrome (IBS). Such problems may be secondary to changes in autonomous neuronal structure and function elicited by the endometriotic elements, which may cause a "visceral syndrome" with the above mentioned symptoms. The investigators hypothesize that dietary treatment will improve the experience of gastrointestinal symptoms, pain and quality of life in patients with endometriosis-related irritable bowel syndrome. The aim of this first randomized, placebo controlled pilot study investigating patients with both endometriosis and IBS, is to test the application of a low FODMAP diet and a placebo diet for endometriosis-related IBS-like symptoms in order to stablish a platform for a randomized controlled study. Thus, the primary aim of this pilot study is to investigate the applicability of a placebo diet in patients with endometriosis and to investigate the compliance in both intervention group and control group. In addition, the aim is to investigate whether the participants find the diet manageable and whether they are able to identify the placebo diet.

Conditions

Endometriosis; Irritable Bowel Syndrome; Visceral Syndrome; Visceral Hypersensitivity

Keywords

Endometriosis; IBS; Irritable bowel syndrome; low FODMAP diet; FODMAPs; visceral syndrome; fermentable carbohydrates; visceral hypersensitivity; cross organ effect

Outcome Measures

Primary Outcomes (3)

• Compliance to the diet measured by a self-administered questionnaire with a percentage scale for every meal consumed

  four weeks

• How manageable the participants experience the diet, measured by semi-quantitative questionnaire designed by the study group

  four weeks

• Identification of intervention group measured by the question: "What group do you think you were assigned to?"

  four weeks

Secondary Outcomes (6)

• Gastrointestinal symptoms measured by the questionnaire: The Gastrointestinal symptom rating scale (GSRS) irritable bowel syndrome (IBS) version

  four weeks

• IBS related quality of life measured by the questionnaire: Irritable bowel syndrome - Quality of Life

  four weeks

• Endometriosis related quality of life measured by the questionnaire: The Endometriosis Health Profile (EHP-30)

  four weeks

• Intake of nutrients calculated in by: The Monash University Comprehensive Food Frequency Questionnaire (CNAQ) based on the participants self-reported 7-days food registration

  four weeks

• Intermenstrual pain measured by VAS scale

  four weeks

Study Arms (2)

Low FODMAP diet

EXPERIMENTAL

This group will follow a exclusion diet called low FODMAP diet, which is a diet with restriction of fermentable carbohydrates. The patients will be guided on how to avoid some foods and how to include others. The patients will follow the diet for four weeks.

Other: Diet low in fermentable carbohydrates (low FODMAP diet)

Control diet

PLACEBO COMPARATOR

This group will follow a placebo diet, which is designed to imitate the low FODMAP diet by restricting specific foods. However, it is randomly selected foods that will be excluded in this diet, so that it works only as a control diet. The patients in this group will also be guided how to follow the diet for four weeks.

Other: Diet low in fermentable carbohydrates (low FODMAP diet)

Interventions

Diet low in fermentable carbohydrates (low FODMAP diet) OTHER

The participants follow the diet in 4 weeks. They have been provided with some foods (bread, pasta, cereal products), but will by the rest themselves. They have been provided with lists of foods to include and foods to avoid. They have also been provided with suggestions to a 4 week meal plan, based in their individual need for energy.

Control diet; Low FODMAP diet

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: female
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Signed informed consent
• Age 18-50 years
• Fluid spoken and written Danish
• Diagnosed endometriosis (laparoscopy and/or MR-scan) at least one year ago and sufficient treated regarding medicine and surgery. Participant will be asked to bring a copy of their medical record from the hospital or from www.sundhed.dk to verify the diagnosis.
• Diagnosis of irritable bowel syndrome according to the Rome III criteria. Both previous diagnosis and undiagnosed patients are included, as long as the study group evaluates that the patient meets the Rome III criteria.

You may not qualify if:

• Premature menopause
• Organic bowel disease (Celiac disease, IBD, bowel endometriosis, malignant disease)
• New therapeutic interventions during study period (medical/lifestyle/psychological). Already ongoing treatment is accepted.
• Psychiatric disorder, psychotropic drugs
• Patients, who the dietician accesses are familiar with low FODMAP diet and therefore is able to identify the placebo diet
• Patients with complicated dietary needs, e.g. severe allergies or intolerances (including lactose and fructose intolerance), athletes, any type of vegetarianism or metabolic diseases
• Pregnancy or planned pregnancy during the study period

Sponsors & Collaborators

• University of Aarhus: lead

Study Sites (1)

Aarhus University Hospital

Aarhus, Denmark

Location

MeSH Terms

Conditions

Endometriosis; Irritable Bowel Syndrome

Interventions

FODMAP Diet

Condition Hierarchy (Ancestors)

Genital Diseases, Female; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Genital Diseases; Colonic Diseases, Functional; Colonic Diseases; Intestinal Diseases; Gastrointestinal Diseases; Digestive System Diseases

Intervention Hierarchy (Ancestors)

Elimination Diets; Diet; Nutritional Physiological Phenomena; Diet, Food, and Nutrition; Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 15, 2016
• First Posted: October 5, 2016
• Study Start: July 3, 2017
• Primary Completion: December 1, 2017
• Study Completion: February 1, 2018
• Last Updated: May 17, 2018

Record last verified: 2017-10

Locations

DK (1)