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The objective of this randomized, double-blind, placebo-controlled study is to evaluate the effectiveness of Skal Pro in alleviating symptoms, enhancing stool consistency, improving quality of life, and addressing psychological distress in individuals diagnosed with irritable bowel syndrome (IBS), as compared to those who receive no intervention.
Irritable bowel syndrome (IBS) is a condition linked to disturbances in the gut-brain axis and dysbiosis. Although probiotic modulation of dysbiosis appears promising for IBS treatment, identifying the specific beneficial strains remains uncertain. Furthermore, even with an effective probiotic strain, variations in efficacy among populations are observed due to environmental heterogeneity, particularly dietary influences.
This study seeks to provide efficacy insights into Skal Pro powder 2g (containing Lactobacillus plantarum 299v 1x10^10 colony forming unit (CFU) and GOS), shedding light on the unique mechanisms of LP299V within the Malaysian population through a randomized controlled trial (RCT).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Skal Pro | Experimental | Skal Pro in the form of 2g sachet powder contains 10 billion CFU of freeze-dried Lactobacillus plantarum 299v (LP299V) and galactooligosaccharides (GOS). |
|
| Placebo | Placebo Comparator | Placebo is an oral formulation of inert powder. Placebo and Skal Pro are identical in shape, size, colour, packaging and taste. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Skal Pro | Combination Product | One sachet Skal Pro per day containing Lactobacillus plantarum 299v 1x10^10 CFU and GOS |
|
| Measure | Description | Time Frame |
|---|---|---|
| Improving the severity of symptoms in individuals with IBS, assessed by IBS Symptom Severity Scale (IBSSSS) | IBSSS questionnaire contains five questions that measures, on a 100-point visual analogue scale (VAS), the severity of abdominal pain, the frequency of abdominal pain, the severity of abdominal distension, dissatisfaction with bowel habits, and interference with quality of life (QOL). All five components contribute to the scores equally, yielding a theoretically range of 0 - 500, with a higher score indicating worse condition. The Malay version questionnaire will be used. | Assessed at baseline, Week 1, Week 2, and Week 4. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in stool consistency (Bristol Stool Scale), assessed by daily stool diary | Daily diary of stool consistency of each bowel movement based on Bristol Stool Scale (Type 1-7), from type 1-2 = separate hard lump stool, type 3-4= ideal stool, type 5-7 =loose stool | Assessed daily from baseline to Week 4. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jonathan Khor | Contact | +60122888024 | jonathankhor@epplusgroup.com |
| Name | Affiliation | Role |
|---|---|---|
| Yeong Yeh Lee, MD, PhD | Hospital Universiti Sains Malaysia | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Universiti Sains Malaysia | Recruiting | Kubang Kerian | Kelantan | 16150 | Malaysia |
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| Placebo | Other | One sachet per day identical in shape, size, colour, packaging and taste to the Skal Pro sachet |
|
| Change in stool frequency and satisfaction after passing stool, assessed by daily stool diary |
Daily diary of number of bowel movements. |
| Assessed daily from baseline to Week 4. |
| Change in abdominal bloating, assessed by Bloating Severity Questionnaire (BSQ) | Originally developed by Thiwan et al., this research group then translated and validated the BSQ in the Malay language (BSQ-M) [13]. There are 2 sub-scales, the 6-item Sev-Gen (Severity-General) and 5-item Sev-24 (Severity-24 hour) with responses in seven-point Likert scale on different degree of severity (from 1 = never to 7=always). For this study, only the Sev-Gen will be used. | Assessed at baseline, Week 1, Week 2, and Week 4. |
| Improvement in Quality of Life, assessed by EQ-5D-5L Questionnaire | The 5-level EQ-5D version (EQ-5D-5L) was introduced by the EuroQol Group in 2009, and consist of 2 sections, 1) the EQ-5D descriptive system and 2) the EQ visual analogue scale (EQ VAS). The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain or discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The EQ VAS records the patient's self-rated health on a vertical visual analogue scale, where the endpoints are labelled 'The best health the participant can imagine' and 'The worst health the participant can imagine'. The VAS can be used as a quantitative measure of health outcome that reflect the patient's own judgement. The Malay version questionnaire will be used. | Assessed at baseline, Week 1, Week 2, and Week 4. |
| Change in Visceral Sensitivity Index | The Visceral Sensitivity Index (VSI) is a 15-item questionnaire which measures gastrointestinal symptom-specific anxiety. Replies to each item are provided on a 6-point scale from "strongly disagree" (scored as 0) to "strongly agree" (scored as 5). A Malay version of the questionnaire was developed using standard forward-back translation procedures. The Malay version questionnaire will be used. | Assessed at baseline, Week 1, Week 2, and Week 4. |
| Assessment of psychological dysfunction suing Catastrophizing Questionnaire | The Coping Strategies Questionnaire (CSQ) - Catastrophizing (CAT) subscale consists of six questions on a 6-point Likert scale, with response options ranging from 0 (never) to 5 (very frequently). The Malay version questionnaire will be used. | Assessed at baseline, Week 1, Week 2, and Week 4. |
| ID | Term |
|---|---|
| D043183 | Irritable Bowel Syndrome |
| D005767 | Gastrointestinal Diseases |
| D003109 | Colonic Diseases, Functional |
| D007410 | Intestinal Diseases |
| D004066 | Digestive System Diseases |
| D010335 | Pathologic Processes |
| D003108 | Colonic Diseases |
| D004194 | Disease |
| ID | Term |
|---|---|
| D013568 | Pathological Conditions, Signs and Symptoms |
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