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This prospective, randomized, placebo-controlled, double-blind study will be conducted to assess the efficacy of 2 billion CFU/day of B. coagulans Unique IS2 on improving bowel movement characteristics, gastrointestinal-related symptoms and quality of life in healthy adult participants who are experiencing more than 3.0 but less than 6.0 complete spontaneous bowel movements (CSBM) per week on average.
Following a run-in period of 14 days to assess participants' baseline bowel habits, they are randomized to either B. coagulans or placebo for one month. The primary endpoint is change from baseline at 4 weeks in stool frequency in the test product group compared to the placebo group for average number of daily bowel movements over the week prior to the study visits. Secondary endpoints are stool frequency at weeks 1, 2, 3, stool quality measured by Bristol stool type scores, and gastrointestinal quality of life index (GIQLI) scores and subcategories (social, physical, emotional, symptoms).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bacillus coagulans | Experimental | 2 billion CFU Bacillus coagulans Unique IS2 per capsule |
|
| Placebo | Placebo Comparator | Appearance-matched capsule |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Capsule | Other | 1 cap daily at same time of the day with or without food for 4 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Stool frequency | Number of daily bowel movements | Change from 7 day average prior to baseline versus 7 day average in fourth week. A significant increase is desirable. |
| Measure | Description | Time Frame |
|---|---|---|
| Stool frequency | Number of daily bowel movements | Change from 7 day average prior to baseline to week 1, week 2 and week 3 averages. An increase from baseline stool frequency at Weeks 1, 2, or 3 in the B coagulans group, which is significantly better than the change in the placebo group, is desirable. |
| Stool quality |
| Measure | Description | Time Frame |
|---|---|---|
| Fecal microbiome composition | Exploratory outcome: Microbial populations and their relative abundance assessed via 16S rRNA sequencing from fecal samples | Shifts from baseline to Week 4. A better composition is desirable. |
| Ratio of complete spontaneous bowel movements (SBMs) to total bowel movements |
Inclusion Criteria:
Healthy male and female adult participants who are 18 to 65 years of age (inclusive).
In good general health and good oral health (no active or uncontrolled diseases or conditions).
Have a body mass index (BMI) between 18.5 to 34.9 kg/m2 (inclusive).
Have normal (or acceptable to the investigator) vital signs (blood pressure and heart rate) at screening (Visit 1) and baseline (Visit 2) and normal (or acceptable to the investigator) physical exam findings (if applicable) at screening.
Individuals of childbearing potential must agree to practice a medically acceptable form of birth control for a defined timeframe prior to the start of run-in and throughout the study to avoid pregnancy, including:
Agree to refrain from treatments in the defined timeframes as outlined in Section 6.5.
Agree not to change current dietary habits (with the exception of avoiding pro- and prebiotic supplements), smoking and alcohol consumption habits, and activity/training levels starting from the beginning of the run-in period and for the duration of the study.
Agree to avoid anal penetration for 72 hours prior to fecal sample collection.
Agree to not receive a vaccine for COVID-19 throughout the duration of the study.
Willing and able to agree to the requirements and restrictions of this study, be willing to give voluntary consent, be able to understand and read the questionnaires, and carry out all study-related procedures.
At Visit 2/baseline, based on study diary data, an average of ≥3.0 and <7.0 weekly SBM (occurring without use of laxatives/suppositories/enema/manual maneuvers to defecate on the day of bowel movements or the day before) during the run-in period.
At Visit 2/baseline, achieve a study product compliance of 80-120% (inclusive) for the run-in period.
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Anthony Bier, MD | Nutrasource Pharmaceutical and Nutraceutical Services, Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nutrasource Pharmaceutical and Nutraceutical Services, Inc.: Nutrasource Clinical Trial Site | Guelph | Ontario | N1G 0B4 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40456531 | Derived | LeMoire A, Replogle R, Shinn L, Kamil A, Lin L, Kuttenkeuler AP, Baisley J, Wang J, Girard SA, Recker S, Bier A. Bacillus coagulans Unique IS2 improves stool characteristics in healthy adults with infrequent bowel movements: a randomized, double-blind, placebo-controlled trial. Benef Microbes. 2025 Jun 1;16(5):533-543. doi: 10.1163/18762891-bja00072. |
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All capsules have the same appearance
Bristol stool chart scale rated Type 1 (separate hard lumps) to Type 7 (watery, no solid pieces) |
| Change from 7 day average prior to baseline to week 1, 2, 3 and 4 average scores. An increase from baseline stool frequency in the B. coagulans group at weeks 1,2,3,4 which is significantly better than the change in the placebo group, is desirable. |
| Gastrointestinal quality of life index | Gastrointestinal quality of life index (GIQLI) total scores based on subcategory scores (social, physical, emotional, symptoms). 36 items are each rated from 0 (all the time) to 4 (never) | Change from baseline score to week 4 score. An improved score is desirable. |
The ratio of complete SBM to total bowel movements over one week will be multiplied by 100. |
| Changes from baseline to Week 4 in the test product group compared to the placebo group. More compete spontaneous bowel movements are better. |
| ID | Term |
|---|---|
| D002214 | Capsules |
| ID | Term |
|---|---|
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
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