Clinical trial NCT01413945: Ileocecal Sphincter Reflex by Cecal Distension During Colonoscopy
Official title: Evaluation of the Ileocecal Valve in Patients With and Without Irritable Bowel Syndrome.(IBS)
Study type: OBSERVATIONAL
Overall status: TERMINATED
Conditions: Irritable Bowel Syndrome
Keywords: Ileocecal valve
Irritable bowel syndrome
small bowel bacteria
Lead sponsor: Northwell Health
Sponsor class: OTHER
First posted: 2011-08-10
Enrollment: 2
Sex: ALL
Minimum age (years): 20
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients with who are undergoing routine screening colonoscopies.

Brief summary: The aim of the current study is to test the hypothesis that patients with IBS may have a defective ICV pressures and may have small bowel bacterial overgrowth. The goal of the current study is to identify the role and competence of ileocecal valve (ICV) in patients with irritable bowel syndrome.

The primary objective is to measure the pressure of the ileocecal valve in patients with and without irritable bowel syndrome (IBS). The Ileocecal valve reflux pressures during air insufflation of cecum will be used.

Detailed description: This is an outpatient study. There will be no requirement to stay overnight in the hospital. The research will be conducted in the gastroenterology section of the department of Medicine in North shore university hospital and in North shore long island Jewish medical center. Both these hospitals are tertiary care centers with adequate facilities for the safe and appropriate conduct of this research. Participants must meet all eligibility criteria and sign the consent form before enrolling in the study. This is a cohort study with 2 groups (patients with IBS and participants without IBS). Patients will be enrolled into one of these two categories based on their medical history, signs and symptoms and questionnaire. There are no controlled compounds used in this study. There is no treatment involved in this study. There are 2 study related visits per subject.

Based on questionnaire we plan to recruit 25 participants who meet the criteria of IBS and 25 participants who do not meet the criteria of IBS (Total of 50 participants in the study). Patients with IBS are those who meet the criteria of IBS based on their symptoms and the responses to a validated ROME III - questionnaire. All other participants who do not meet the criteria for IBS are classified as non-IBS participants. All the participants should be having a clinically indicated colonoscopy.

Eligibility criteria: Inclusion Criteria:

* Patients with a history of small bowel bacterial overgrowth or irritable bowel syndrome and who are undergoing routine colonoscopies or subjects who are undergoing routine colonoscopy and test positive for small bowel bacterial overgrowth will be candidates. If the patient has prior lactulose breath test done for clinical purposes then repeat lactulose breath test will not be required. If no prior lactulose breath test has been performed then it will be done as part of this research study. In addition patients who test negative for SBBO will be candidates for the control population.

Exclusion Criteria:

* Medications-Subjects on any medication that could affect the ileocecal valve high-pressure zone will be excluded; this includes use of prokinetic agents, current use of any antibiotics and anticholinergics. Patients will be excluded if the lactulose breath test is done on antibiotics or during the colonoscopy preparation.

GI symptoms, conditions and disorders: In addition exclusion criteria will include a history of ileocecal resection or disease affecting the colon and/or small bowel including crohn's disease, ulcerative colitis or diseases causing diarrhea.

Primary outcomes:
measure: Pressure generated in ICV during Cecal distention
timeFrame: 10-15 minutes
Secondary outcomes:
Other outcomes:
Locations:
city: New Hyde Park
country: United States
facility: LIJ Medical Center- NSLIJ Health System
state: New York
Study officials:
affiliation: Northwell Health
name: Larry S Miller, MD
role: PRINCIPAL_INVESTIGATOR
References:
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citation: SINGLETON AO Jr, REDMOND DC 2nd, MCMURRAY JE. ILEOCECAL RESECTION AND SMALL BOWEL TRANSIT AND ABSORPTION. Ann Surg. 1964 May;159(5):690-4. doi: 10.1097/00000658-196405000-00006. No abstract available.
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