Clinical Trial: Effect of Diet on Intestinal Gas Production and Evacuation in Healthy Subjects and Flatulent Patients

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Objective Markers Flatulence: Determination of Gas Production and Evacuation in Response to Dietary Manipulations

Brief Summary:

Background Some patients complain of excessive evacuation, which may become socially disabling (Azpiroz F & Malagelada J-R, 2005). However, there no systematic investigation on the range of gas evacuation in healthy subjects and in subjects complaining of flatulence under basal conditions and in response to a high-flatulogenic diet (Azpiroz F & Levitt DG, 2009).

Hypothesis Patients complaining of excessive passage of gas per anus have more intestinal gas production and more anal gas evacuation during basal conditions and in response to a high flatulogenic diet than healthy subjects. This abnormality is related to the differences in colonic microflora.

Objectives

  • To determine the normal range of intestinal gas evacuation under basal conditions and in response to a high flatulogenic diet.
  • In patients complaining of flatulence, to determine whether intestinal gas evacuation under basal conditions and in response to a high flatulogenic diet is increased.
  • To identify differences in the microbiota pattern in subjects with normal and excessive anal gas evacuation.
  • In patients complaining of flatulence, to determine the segmental distribution of intestinal gas after a diet challenge.

Methods Healthy subjects (n=20) and patients complaining of flatulence (n=30) will undergo a 3-day basal phase on their current diet and a 3-day challenge phase on a high-flatulogenic diet; patients will be followed-up for 7 days on a low-flatulogenic diet. The following g measurements will be performed: daily measurement of the number of anal gas passages with an event marker, continuous recording of an

Detailed Summary:

Background Some patients complain of excessive evacuation, which may become socially disabling (Azpiroz F & Malagelada J-R, 2005). However, the physiology and pathophysiology of flatulence remains poorly understood (Azpiroz F & Levitt DG, 2009).

Gas evacuated by anus originates by-and-large in the colon, where unabsorbed meal residues are fermented by colonic bacteria (Anderson et al., 1981;Levitt et al., 1987;Flourie et al., 1988). Indeed, it has been shown that some food components are incompletely absorbed in the small bowel and enter the colon (Wolever & Robb, 1992;Grimble, 1989;Steggerda FR, 1968;Wagner et al., 1977;Steggerda F.R. & Dimmick, 1966;Stone-Dorshow & Levitt, 1987;Wursch et al., 1989) and that other intraluminal substrates interfere with the absorption of nutrients (Boibin M et al., 1998;Hamberg et al., 1989;Brugge & Rosenfeld, 1987;Taylor et al., 1986;Layer et al., 1986). Hence, the volume of gas production and anal evacuation is determined by two main factors: the diet, particularly the amount of fermentable residues, and the individual composition of colonic microflora. Within subjects, gas output varies in relation to the diet (Steggerda FR, 1968;Kirk, 1949). However, there is a great interindividual variability, and gas evacuation in subjects maintained on a similar diet may differ substantially.

It has been shown that healthy subjects on a normal diet containing 200 g of beans evacuate 705 mL gas per 24 hours, whereas with a fiber the diet gas evacuation was 214 mL (Tomlin et al., 1991). In healthy subjects the frequency of gas evacuation is variable, usually around 10 evacuation per day (Furne & Levitt, 1996). Based on observations on a patient that who passed large amounts of flatus, a classification of foodstuffs depending on their gas producing capacity was elaborated (
Sponsor: Hospital Universitari Vall d'Hebron Research Institute

Current Primary Outcome: Intestinal gas evacuation [ Time Frame: 7 days ]

Intestinal gas evacuation will be measured during a 3-day basal phase on their current diet and a 3-day challenge phase on a high flatulogenic diet


Original Primary Outcome: Same as current

Current Secondary Outcome: Colonic microbiota pattern [ Time Frame: 7 days ]

Colonic microbiota pattern will be measured during a 3-day basal phase on their current diet and a 3-day challenge phase on a high flatulogenic diet


Original Secondary Outcome: Same as current

Information By: Hospital Universitari Vall d'Hebron Research Institute

Dates:
Date Received: February 7, 2011
Date Started: November 2010
Date Completion:
Last Updated: March 22, 2012
Last Verified: March 2012