Symbiotic Use in Post-Bariatric Surgery Patients
Do Symbiotics Provide Helpful Benefits in Gastrointestinal Related Issues in Weight Loss Surgery Patients?
1 other identifier
interventional
110
1 country
1
Brief Summary
The purpose of this double blind, randomized control trial would be to test the efficacy of a once daily, multi strain symbiotic on gut health changes in weight loss surgery patients by testing stool samples prior to administration and then three months post administration of the symbiotic to monitor any changes in bacteria in the stool samples. Study participants will also complete a survey that evaluates their bowel habits, stool consistency, and gastrointestinal related symptoms.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started Jan 2024
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
January 8, 2024
CompletedFirst Submitted
Initial submission to the registry
February 1, 2024
CompletedFirst Posted
Study publicly available on registry
February 9, 2024
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 1, 2024
CompletedStudy Completion
Last participant's last visit for all outcomes
December 1, 2024
CompletedFebruary 9, 2024
February 1, 2024
7 months
February 1, 2024
February 1, 2024
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Symbiotic Changes in Stool Samples
The primary objective will be to test the efficacy of a once daily, multi-strain symbiotic on gut health changes in weight loss surgery patients by testing stool samples prior to administration and then three months after administration of a symbiotic or placebo. Chi-square tests will be performed to show associations between symbiotic intake and stool bacteria diversity and concentrations.
90 days
Secondary Outcomes (3)
Bristol Stool Scale Weekly Changes
12 weeks
Frequency of Weekly Stools
12 weeks
Gastrointestinal Related Symptoms
12 weeks
Study Arms (2)
Symbiotic Group
EXPERIMENTALAn over-the counter, once daily symbiotic capsule including: 15 billion CFU probiotic blend and 250mg of prebiotic.
Fiber Group
PLACEBO COMPARATOROnce daily capsule of microcrystalline cellulose.
Interventions
One-a-day administration of a capsule supplement containing:15 billion CFU probiotic blend (Lactobacillus acidophilus La-14, Bifidobacterium longum BB536, Lactobacillus acidophilus NCFM, Lactobacillus rhamnosus GG, Lactobacillus gasseri Lg-36) and 250mg of chicory root inulin.
Eligibility Criteria
You may qualify if:
- months or greater post malabsorptive weight loss procedure
You may not qualify if:
- LapBand or Intra-gastric balloon patients due to lack of surgical alteration to gut
- Individuals who have not had an approved weight loss procedure
- Individuals with impaired gastrointestinal function which would impair ingestion of oral supplement
- Individuals with impaired gastrointestinal function which would impair ability to collect stool sample
- Inability to comprehend and complete assessment tools
- Inability to adhere to 90-day capsule supplement administration
- Currently taking daily probiotic, prebiotic, or symbiotic supplement
- Currently taking antibiotic treatment from physician
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- University of North Floridalead
- Celebrate Nutritional Supplementscollaborator
Study Sites (1)
University of North Florida
Jacksonville, Florida, 32224, United States
Related Publications (51)
Lim Y, Boster J. Obesity and Comorbid Conditions. StatPearls. Published online October 25, 2021. Accessed March 28, 2022. https://www.ncbi.nlm.nih.gov/books/NBK574535/
BACKGROUNDObesity Medicine Association. AMA Classifies Obesity as a Disease | Obesity Medicine AssociationMain. Published June 19, 2013. Accessed May 2, 2022.
BACKGROUNDHales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of Obesity and Severe Obesity Among Adults: United States, 2017-2018. NCHS Data Brief. 2020 Feb;(360):1-8.
PMID: 32487284BACKGROUNDWard ZJ, Bleich SN, Cradock AL, Barrett JL, Giles CM, Flax C, Long MW, Gortmaker SL. Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity. N Engl J Med. 2019 Dec 19;381(25):2440-2450. doi: 10.1056/NEJMsa1909301.
PMID: 31851800BACKGROUNDBhutani S, vanDellen MR, Cooper JA. Longitudinal Weight Gain and Related Risk Behaviors during the COVID-19 Pandemic in Adults in the US. Nutrients. 2021 Feb 19;13(2):671. doi: 10.3390/nu13020671.
PMID: 33669622BACKGROUNDKim J, Eisenberg D, Azagury D, Rogers A, Campos GM. American Society for Metabolic and Bariatric Surgery position statement on long-term survival benefit after metabolic and bariatric surgery. Surg Obes Relat Dis. 2016 Mar-Apr;12(3):453-459. doi: 10.1016/j.soard.2015.11.021. Epub 2015 Nov 27.
PMID: 26944548BACKGROUNDAmerican Society of Metabolic and Bariatric Surgery. Access to Care Fact Sheet. Published 2011. Accessed March 29, 2022. https://asmbs.org/resources/access-to-care-fact-sheet
BACKGROUNDEisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, De Luca M, Faria SL, Goodpaster KPS, Haddad A, Himpens JM, Kow L, Kurian M, Loi K, Mahawar K, Nimeri A, O'Kane M, Papasavas PK, Ponce J, Pratt JSA, Rogers AM, Steele KE, Suter M, Kothari SN. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2022 Dec;18(12):1345-1356. doi: 10.1016/j.soard.2022.08.013. Epub 2022 Oct 21.
PMID: 36280539BACKGROUNDCarter J, Chang J, Birriel TJ, Moustarah F, Sogg S, Goodpaster K, Benson-Davies S, Chapmon K, Eisenberg D. ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery. Surg Obes Relat Dis. 2021 Dec;17(12):1956-1976. doi: 10.1016/j.soard.2021.08.024. Epub 2021 Sep 3. No abstract available.
PMID: 34629296BACKGROUNDYoudim A. Bariatric Surgery. Merck Manual Professional Version. Published August 2021. Accessed April 17, 2022. https://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery
BACKGROUNDStefater MA, Wilson-Perez HE, Chambers AP, Sandoval DA, Seeley RJ. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev. 2012 Aug;33(4):595-622. doi: 10.1210/er.2011-1044. Epub 2012 May 1.
PMID: 22550271BACKGROUNDCenter for Disease Control and Prevention. Adult Obesity Facts. Published September 30, 2021. Accessed March 28, 2022. https://www.cdc.gov/obesity/data/adult.html
BACKGROUNDOwens DK. Interpretation of cost-effectiveness analyses. J Gen Intern Med. 1998 Oct;13(10):716-7. doi: 10.1046/j.1525-1497.1998.00211.x. No abstract available.
PMID: 9798822BACKGROUNDWeight Management Dietetic Practice Group. Pocket Guide to Bariatric Surgery. Third Edition. (Isom KA, Majumdar MC, eds.).; 2022.
BACKGROUNDInternational Federation of Surgery for Obesity. Gastric Bypass Surgery. Accessed April 12, 2022. https://www.ifso.com/roux-en-y-gastric-bypass/
BACKGROUNDInternational Federation of Surgery for Obesity. Biliopancreatic Diversion. Accessed April 12, 2022. https://www.ifso.com/bilio-pancreatic-diversion-with-duodenal-switch/
BACKGROUNDInternational Federation of Surgery for Obesity. Laparoscopic Single Anastomosis Duodenal-Ileal bypass with Sleeve (SADI-S). Accessed April 12, 2022. https://www.ifso.com/single-anastomosis-duodenal-Ileal-bypass-with-sleeve/
BACKGROUNDArterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. JAMA. 2020 Sep 1;324(9):879-887. doi: 10.1001/jama.2020.12567.
PMID: 32870301BACKGROUNDAmerican Society for Metabolic and Bariatric Surgery. Estimate of Bariatric Surgery Numbers, 2011-2019. Published March 2021. Accessed April 11, 2022.
BACKGROUNDMechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, Kushner RF, Lindquist R, Pessah-Pollack R, Seger J, Urman RD, Adams S, Cleek JB, Correa R, Figaro MK, Flanders K, Grams J, Hurley DL, Kothari S, Seger MV, Still CD. CLINICAL PRACTICE GUIDELINES FOR THE PERIOPERATIVE NUTRITION, METABOLIC, AND NONSURGICAL SUPPORT OF PATIENTS UNDERGOING BARIATRIC PROCEDURES - 2019 UPDATE: COSPONSORED BY AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY, THE OBESITY SOCIETY, AMERICAN SOCIETY FOR METABOLIC & BARIATRIC SURGERY, OBESITY MEDICINE ASSOCIATION, AND AMERICAN SOCIETY OF ANESTHESIOLOGISTS - EXECUTIVE SUMMARY. Endocr Pract. 2019 Dec;25(12):1346-1359. doi: 10.4158/GL-2019-0406. Epub 2019 Nov 4.
PMID: 31682518BACKGROUNDTabesh MR, Maleklou F, Ejtehadi F, Alizadeh Z. Nutrition, Physical Activity, and Prescription of Supplements in Pre- and Post-bariatric Surgery Patients: a Practical Guideline. Obes Surg. 2019 Oct;29(10):3385-3400. doi: 10.1007/s11695-019-04112-y.
PMID: 31367987BACKGROUNDLysen LK, Isreal DA. Nutrition in Weight Management. In: Mahan KL, Escott-Stump S, Raymond JL, eds. Krause's Food and Nutrition Care Process. 13th ed. Elsevier; 2012:462-488.
BACKGROUNDSherf Dagan S, Goldenshluger A, Globus I, Schweiger C, Kessler Y, Kowen Sandbank G, Ben-Porat T, Sinai T. Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice. Adv Nutr. 2017 Mar 15;8(2):382-394. doi: 10.3945/an.116.014258. Print 2017 Mar.
PMID: 28298280BACKGROUNDSawaya RA, Jaffe J, Friedenberg L, Friedenberg FK. Vitamin, mineral, and drug absorption following bariatric surgery. Curr Drug Metab. 2012 Nov;13(9):1345-55. doi: 10.2174/138920012803341339.
PMID: 22746302BACKGROUNDSherf-Dagan S, Buch A, Ben-Porat T, Sakran N, Sinai T. Vitamin E status among bariatric surgery patients: a systematic review. Surg Obes Relat Dis. 2021 Apr;17(4):816-830. doi: 10.1016/j.soard.2020.10.029. Epub 2020 Nov 10.
PMID: 33323330BACKGROUNDWorld Gastroenterology Organisation (WGO). WGO Practice Guidelines Probiotics and Prebiotics. February 2017. https://www.worldgastroenterology.org/guidelines/probiotics-and-prebiotics
BACKGROUNDInternational Scientific Association for Probiotics and Prebiotics. The ISAPP quick guide to probiotics for health professionals: History, efficacy, and safety. December, 2019. https://isappscience.org/for-clinicians/resources/probiotics/#toggle-id-1
BACKGROUNDSweeney TE, Morton JM. The human gut microbiome: a review of the effect of obesity and surgically induced weight loss. JAMA Surg. 2013 Jun;148(6):563-9. doi: 10.1001/jamasurg.2013.5.
PMID: 23571517BACKGROUNDZhang Y, Yan T, Xu C, Yang H, Zhang T, Liu Y. Probiotics Can Further Reduce Waist Circumference in Adults with Morbid Obesity after Bariatric Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2021 Apr 1;2021:5542626. doi: 10.1155/2021/5542626. eCollection 2021.
PMID: 33859706BACKGROUNDWang Y, Wu XT, Chen J. Effect of Probiotic Supplementation on Weight Loss, Inflammatory Factors, and Metabolic Effects in Patients Undergoing Bariatric Surgery. Obes Surg. 2022 May;32(5):1779-1782. doi: 10.1007/s11695-022-05974-5. Epub 2022 Mar 4. No abstract available.
PMID: 35243603BACKGROUNDSeganfredo FB, Blume CA, Moehlecke M, Giongo A, Casagrande DS, Spolidoro JVN, Padoin AV, Schaan BD, Mottin CC. Weight-loss interventions and gut microbiota changes in overweight and obese patients: a systematic review. Obes Rev. 2017 Aug;18(8):832-851. doi: 10.1111/obr.12541. Epub 2017 May 19.
PMID: 28524627BACKGROUNDFarup PG, Valeur J. Changes in Faecal Short-Chain Fatty Acids after Weight-Loss Interventions in Subjects with Morbid Obesity. Nutrients. 2020 Mar 18;12(3):802. doi: 10.3390/nu12030802.
PMID: 32197409BACKGROUNDZhang H, DiBaise JK, Zuccolo A, Kudrna D, Braidotti M, Yu Y, Parameswaran P, Crowell MD, Wing R, Rittmann BE, Krajmalnik-Brown R. Human gut microbiota in obesity and after gastric bypass. Proc Natl Acad Sci U S A. 2009 Feb 17;106(7):2365-70. doi: 10.1073/pnas.0812600106. Epub 2009 Jan 21.
PMID: 19164560BACKGROUNDFouladi F, Brooks AE, Fodor AA, Carroll IM, Bulik-Sullivan EC, Tsilimigras MCB, Sioda M, Steffen KJ. The Role of the Gut Microbiota in Sustained Weight Loss Following Roux-en-Y Gastric Bypass Surgery. Obes Surg. 2019 Apr;29(4):1259-1267. doi: 10.1007/s11695-018-03653-y.
PMID: 30604078BACKGROUNDZuo HJ, Xie ZM, Zhang WW, Li YR, Wang W, Ding XB, Pei XF. Gut bacteria alteration in obese people and its relationship with gene polymorphism. World J Gastroenterol. 2011 Feb 28;17(8):1076-81. doi: 10.3748/wjg.v17.i8.1076.
PMID: 21448362BACKGROUNDWoodard GA, Encarnacion B, Downey JR, Peraza J, Chong K, Hernandez-Boussard T, Morton JM. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009 Jul;13(7):1198-204. doi: 10.1007/s11605-009-0891-x. Epub 2009 Apr 18.
PMID: 19381735BACKGROUNDAron-Wisnewsky J, Prifti E, Belda E, Ichou F, Kayser BD, Dao MC, Verger EO, Hedjazi L, Bouillot JL, Chevallier JM, Pons N, Le Chatelier E, Levenez F, Ehrlich SD, Dore J, Zucker JD, Clement K. Major microbiota dysbiosis in severe obesity: fate after bariatric surgery. Gut. 2019 Jan;68(1):70-82. doi: 10.1136/gutjnl-2018-316103. Epub 2018 Jun 13.
PMID: 29899081BACKGROUNDCalikoglu F, Barbaros U, Uzum AK, Tutuncu Y, Satman I. The Metabolic Effects of Pre-probiotic Supplementation After Roux-en-Y Gastric Bypass (RYGB) Surgery: a Prospective, Randomized Controlled Study. Obes Surg. 2021 Jan;31(1):215-223. doi: 10.1007/s11695-020-04894-6. Epub 2020 Aug 15.
PMID: 32803709BACKGROUNDKazzi F, Daher N, Zimmerman G, Garcia M, Schmidt N, Scharf K. Effect of Bacillius Coagulans and Galactomannans on Obese Patients Undergoing Sleeve Gastrectomy, A Randomized-Controlled Clinical Trial. Altern Ther Health Med. 2021 Jun;27(S1):138-145.
PMID: 29874199BACKGROUNDShoaib M, Shehzad A, Omar M, Rakha A, Raza H, Sharif HR, Shakeel A, Ansari A, Niazi S. Inulin: Properties, health benefits and food applications. Carbohydr Polym. 2016 Aug 20;147:444-454. doi: 10.1016/j.carbpol.2016.04.020. Epub 2016 Apr 8.
PMID: 27178951BACKGROUNDAnderson JW, Baird P, Davis RH Jr, Ferreri S, Knudtson M, Koraym A, Waters V, Williams CL. Health benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x.
PMID: 19335713BACKGROUNDSinn DH, Song JH, Kim HJ, Lee JH, Son HJ, Chang DK, Kim YH, Kim JJ, Rhee JC, Rhee PL. Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome. Dig Dis Sci. 2008 Oct;53(10):2714-8. doi: 10.1007/s10620-007-0196-4. Epub 2008 Feb 15.
PMID: 18274900BACKGROUNDMaria Remes Troche J, Coss Adame E, Angel Valdovinos Diaz M, Gomez Escudero O, Eugenia Icaza Chavez M, Antonio Chavez-Barrera J, Zarate Mondragon F, Antonio Ruiz Velarde Velasco J, Rafael Aceves Tavares G, Antonio Lira Pedrin M, Cerda Contreras E, Carmona Sanchez RI, Guerra Lopez H, Solana Ortiz R. Lactobacillus acidophilus LB: a useful pharmabiotic for the treatment of digestive disorders. Therap Adv Gastroenterol. 2020 Nov 24;13:1756284820971201. doi: 10.1177/1756284820971201. eCollection 2020.
PMID: 33281937BACKGROUNDKailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol. 2000 Feb;78(1):80-8. doi: 10.1046/j.1440-1711.2000.00886.x.
PMID: 10651933BACKGROUNDPreston K, Krumian R, Hattner J, de Montigny D, Stewart M, Gaddam S. Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2 improve quality-of-life and IBS symptoms: a double-blind, randomised, placebo-controlled study. Benef Microbes. 2018 Sep 18;9(5):697-706. doi: 10.3920/BM2017.0105. Epub 2018 Jun 11.
PMID: 29888656BACKGROUNDPicard C, Fioramonti J, Francois A, Robinson T, Neant F, Matuchansky C. Review article: bifidobacteria as probiotic agents -- physiological effects and clinical benefits. Aliment Pharmacol Ther. 2005 Sep 15;22(6):495-512. doi: 10.1111/j.1365-2036.2005.02615.x.
PMID: 16167966BACKGROUNDBouvier M, Meance S, Bouley C, Berta JL, Grimaud JC. Effects of consumption of a milk fermented by the probiotic strain Bifidobacterium animalis DN-173 010 on colonic transit times in healthy humans. Bioscience Microflora 2001; 20: 43-48.
BACKGROUNDRingel-Kulka T, McRorie J, Ringel Y. Multi-Center, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study to Evaluate the Benefit of the Probiotic Bifidobacterium infantis 35624 in Non-Patients With Symptoms of Abdominal Discomfort and Bloating. Am J Gastroenterol. 2017 Jan;112(1):145-151. doi: 10.1038/ajg.2016.511. Epub 2016 Nov 15.
PMID: 27845337BACKGROUNDKligler B, Cohrssen A. Probiotics. Am Fam Physician. 2008 Nov 1;78(9):1073-8.
PMID: 19007054BACKGROUNDProbiotics: Fact Sheet for Health Professionals. National Institute of Health Office of Dietary Supplements.
BACKGROUNDOuwehand AC. A review of dose-responses of probiotics in human studies. Benef Microbes. 2017 Apr 26;8(2):143-151. doi: 10.3920/BM2016.0140. Epub 2016 Dec 23.
PMID: 28008787BACKGROUND
MeSH Terms
Interventions
Intervention Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- QUADRUPLE
- Who Masked
- PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
February 1, 2024
First Posted
February 9, 2024
Study Start
January 8, 2024
Primary Completion
August 1, 2024
Study Completion
December 1, 2024
Last Updated
February 9, 2024
Record last verified: 2024-02