Skip to main content
Top
Published in: Trials 1/2020

Open Access 01-12-2020 | Irritable Bowel Syndrome | Study protocol

Does propolis affect the quality of life and complications in subjects with irritable bowel syndrome (diagnosed with Rome IV criteria)? A study protocol of the randomized, double-blinded, placebo-controlled clinical trial

Authors: Mahsa Miryan, Pezhman Alavinejad, Mohammadreza Abbaspour, Davood Soleimani, Alireza Ostadrahimi

Published in: Trials | Issue 1/2020

Login to get access

Abstract

Background

Irritable bowel syndrome (IBS) is one of the most frequent and recurrent gastrointestinal diseases. However, up to now, no pharmacological agent has been approved to treat IBS. Emerging evidence showed that inflammation has a vital role in enhancing nervous system sensitivity and perception of abdominal pain in subjects with IBS. Propolis is an herbal substance with a broad spectrum of antioxidants, anti-inflammatory, and prebiotic properties, which might exert beneficial effects to reduce the severity of IBS. The current clinical trial aims to evaluate the efficacy of propolis supplementation on IBS.

Methods

This single-center, randomized, double-blind, placebo-controlled clinical trial will be performed to evaluate the effect of propolis supplementation in adult patients with IBS diagnosed with Rome IV criteria. Fifty-two eligible patients will randomly be allocated to receive a propolis tablet (450 mg, containing 100 mg polyphenol compounds) or identical placebo, twice daily for 6 weeks. The primary outcome of the trial is an improvement in IBS severity from baseline to the sixth week of intervention. The secondary outcomes include the change in weight, waist circumference, and IBS quality of life. We will use the paired sample t test or Mann-Whitney U test for the within-group comparison and independent sample t test or Wilcoxon rank-sum and chi-square test or Fisher’s exact test for the between-group comparison. Besides, a multivariable-adjusted mean effect will be computed using the ANCOVA test.

Discussion

We hypothesize that propolis supplementation would be useful for treating IBS through its antioxidants, anti-inflammatory, and prebiotic properties. This trial will show the results of propolis supplementation, whether positive or negative, on IBS. If the current trial confirms our hypothesis, propolis supplementation can be a new choice in adjunctive therapy of IBS.

Trial registration

Iranian Registry of Clinical Trials IRCT20190708044154N1. Registered on 26 December 2019. Updated on 13 February 2020. https://​en.​irct.​ir/​trial/​40983

Sponsor

Tabriz University of Medical Sciences, Tabriz, Iran
Appendix
Available only for authorised users
Literature
1.
go back to reference Kupfer SS, Jabri B. Pathophysiology of celiac disease. Gastrointest Endosc Clin. 2012;22(4):639–60. Kupfer SS, Jabri B. Pathophysiology of celiac disease. Gastrointest Endosc Clin. 2012;22(4):639–60.
2.
go back to reference Kosako M, Akiho H, Miwa H, Kanazawa M, Fukudo S. Influence of the requirement for abdominal pain in the diagnosis of irritable bowel syndrome with constipation (IBS-C) under the Rome IV criteria using data from a large Japanese population-based internet survey. BioPsychoSocial Med. 2018;12(1):18. Kosako M, Akiho H, Miwa H, Kanazawa M, Fukudo S. Influence of the requirement for abdominal pain in the diagnosis of irritable bowel syndrome with constipation (IBS-C) under the Rome IV criteria using data from a large Japanese population-based internet survey. BioPsychoSocial Med. 2018;12(1):18.
3.
go back to reference Bai T, Xia J, Jiang Y, Cao H, Zhao Y, Zhang L, et al. Comparison of the Rome IV and Rome III criteria for IBS diagnosis: a cross-sectional survey. J Gastroenterol Hepatol. 2017;32(5):1018–25.PubMed Bai T, Xia J, Jiang Y, Cao H, Zhao Y, Zhang L, et al. Comparison of the Rome IV and Rome III criteria for IBS diagnosis: a cross-sectional survey. J Gastroenterol Hepatol. 2017;32(5):1018–25.PubMed
4.
go back to reference Ishihara S, Kawashima K, Fukuba N, Tada Y, Kotani S, Mishima Y, et al. Irritable bowel syndrome-like symptoms in ulcerative colitis patients in clinical remission: association with residual colonic inflammation. Digestion. 2019;99(1):46–51.PubMed Ishihara S, Kawashima K, Fukuba N, Tada Y, Kotani S, Mishima Y, et al. Irritable bowel syndrome-like symptoms in ulcerative colitis patients in clinical remission: association with residual colonic inflammation. Digestion. 2019;99(1):46–51.PubMed
5.
go back to reference Holtmann GJ, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. Lancet Gastroenterol Hepatol. 2016;1(2):133–46.PubMed Holtmann GJ, Ford AC, Talley NJ. Pathophysiology of irritable bowel syndrome. Lancet Gastroenterol Hepatol. 2016;1(2):133–46.PubMed
6.
go back to reference Malani PN. Harrison’s principles of internal medicine. JAMA. 2012;308(17):1813–4. Malani PN. Harrison’s principles of internal medicine. JAMA. 2012;308(17):1813–4.
7.
go back to reference Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014;20(22):6759.PubMedPubMedCentral Saha L. Irritable bowel syndrome: pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014;20(22):6759.PubMedPubMedCentral
8.
go back to reference Ng QX, Soh AYS, Loke W, Lim DY, Yeo W-S. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018;11:345.PubMedPubMedCentral Ng QX, Soh AYS, Loke W, Lim DY, Yeo W-S. The role of inflammation in irritable bowel syndrome (IBS). J Inflamm Res. 2018;11:345.PubMedPubMedCentral
9.
go back to reference Akehurst R, Kaltenthaler E. Treatment of irritable bowel syndrome: a review of randomised controlled trials. Gut. 2001;48(2):272–82.PubMedPubMedCentral Akehurst R, Kaltenthaler E. Treatment of irritable bowel syndrome: a review of randomised controlled trials. Gut. 2001;48(2):272–82.PubMedPubMedCentral
10.
go back to reference Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325–32.PubMed Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, et al. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010;59(3):325–32.PubMed
11.
go back to reference Han K, Wang J, Seo J-G, Kim H. Efficacy of double-coated probiotics for irritable bowel syndrome: a randomized double-blind controlled trial. J Gastroenterol. 2017;52(4):432–43.PubMed Han K, Wang J, Seo J-G, Kim H. Efficacy of double-coated probiotics for irritable bowel syndrome: a randomized double-blind controlled trial. J Gastroenterol. 2017;52(4):432–43.PubMed
12.
go back to reference Suzuki T, Hara H. Role of flavonoids in intestinal tight junction regulation. J Nutr Biochem. 2011;22(5):401–8.PubMed Suzuki T, Hara H. Role of flavonoids in intestinal tight junction regulation. J Nutr Biochem. 2011;22(5):401–8.PubMed
13.
go back to reference Sforcin JM. Biological properties and therapeutic applications of propolis. Phytother Res. 2016;30(6):894–905.PubMed Sforcin JM. Biological properties and therapeutic applications of propolis. Phytother Res. 2016;30(6):894–905.PubMed
14.
go back to reference Huang S, Zhang C-P, Wang K, Li GQ, Hu F-L. Recent advances in the chemical composition of propolis. Molecules. 2014;19(12):19610–32.PubMedPubMedCentral Huang S, Zhang C-P, Wang K, Li GQ, Hu F-L. Recent advances in the chemical composition of propolis. Molecules. 2014;19(12):19610–32.PubMedPubMedCentral
15.
go back to reference Wang K, Jin XL, Li QQ, Sawaya A, Le Leu RK, Conlon MA, et al. Propolis from different geographic origins decreases intestinal inflammation and bacteroides spp. Populations in a model of DSS-induced colitis. Mol Nutr Food Res. 2018;62(17):1800080. Wang K, Jin XL, Li QQ, Sawaya A, Le Leu RK, Conlon MA, et al. Propolis from different geographic origins decreases intestinal inflammation and bacteroides spp. Populations in a model of DSS-induced colitis. Mol Nutr Food Res. 2018;62(17):1800080.
16.
go back to reference Mariano LNB, Arruda C, Somensi LB, Costa APM, Perondi EG, Boeing T, et al. Brazilian green propolis hydroalcoholic extract reduces colon damages caused by dextran sulfate sodium-induced colitis in mice. Inflammopharmacology. 2018;26(5):1283–92.PubMed Mariano LNB, Arruda C, Somensi LB, Costa APM, Perondi EG, Boeing T, et al. Brazilian green propolis hydroalcoholic extract reduces colon damages caused by dextran sulfate sodium-induced colitis in mice. Inflammopharmacology. 2018;26(5):1283–92.PubMed
17.
go back to reference Wang K, Jin X, You M, Tian W, Le Leu RK, Topping DL, et al. Dietary propolis ameliorates dextran sulfate sodium-induced colitis and modulates the gut microbiota in rats fed a western diet. Nutrients. 2017;9(8):875.PubMedCentral Wang K, Jin X, You M, Tian W, Le Leu RK, Topping DL, et al. Dietary propolis ameliorates dextran sulfate sodium-induced colitis and modulates the gut microbiota in rats fed a western diet. Nutrients. 2017;9(8):875.PubMedCentral
18.
go back to reference Sabuncuoglu M, Kismet K, Kilicoglu S, Kilicoglu B, Erel S, Muratoglu S, et al. Propolis reduces bacterial translocation and intestinal villus atrophy in experimental obstructive jaundice. World J Gastroenterol. 2007;13(39):5226–31.PubMedPubMedCentral Sabuncuoglu M, Kismet K, Kilicoglu S, Kilicoglu B, Erel S, Muratoglu S, et al. Propolis reduces bacterial translocation and intestinal villus atrophy in experimental obstructive jaundice. World J Gastroenterol. 2007;13(39):5226–31.PubMedPubMedCentral
19.
go back to reference El-Ghazaly MA, Rashed RR, Khayyal MT. Anti-ulcerogenic effect of aqueous propolis extract and the influence of radiation exposure. Int J Radiat Biol. 2011;87(10):1045–51.PubMed El-Ghazaly MA, Rashed RR, Khayyal MT. Anti-ulcerogenic effect of aqueous propolis extract and the influence of radiation exposure. Int J Radiat Biol. 2011;87(10):1045–51.PubMed
20.
go back to reference Roquetto AR, Monteiro NES, Moura CS, Toreti VC, de Pace F, Santos AD, et al. Green propolis modulates gut microbiota, reduces endotoxemia and expression of TLR4 pathway in mice fed a high-fat diet. Food Res Int. 2015;76(Pt 3):796–803.PubMed Roquetto AR, Monteiro NES, Moura CS, Toreti VC, de Pace F, Santos AD, et al. Green propolis modulates gut microbiota, reduces endotoxemia and expression of TLR4 pathway in mice fed a high-fat diet. Food Res Int. 2015;76(Pt 3):796–803.PubMed
21.
go back to reference Wang K, Jin X, Chen Y, Song Z, Jiang X, Hu F, et al. Polyphenol-rich propolis extracts strengthen intestinal barrier function by activating AMPK and ERK signaling. Nutrients. 2016;8(5):272.PubMedCentral Wang K, Jin X, Chen Y, Song Z, Jiang X, Hu F, et al. Polyphenol-rich propolis extracts strengthen intestinal barrier function by activating AMPK and ERK signaling. Nutrients. 2016;8(5):272.PubMedCentral
22.
go back to reference Karimian J, Hadi A, Pourmasoumi M, Najafgholizadeh A, Ghavami A. The efficacy of propolis on markers of glycemic control in adults with type 2 diabetes mellitus: a systematic review and meta-analysis. Phytother Res. 2019;33(6):1616–26.PubMed Karimian J, Hadi A, Pourmasoumi M, Najafgholizadeh A, Ghavami A. The efficacy of propolis on markers of glycemic control in adults with type 2 diabetes mellitus: a systematic review and meta-analysis. Phytother Res. 2019;33(6):1616–26.PubMed
24.
go back to reference Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11(2):395–402.PubMed Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997;11(2):395–402.PubMed
25.
go back to reference Samadi N, Khosravi HM, Rahmanian M, Shahi MA. Effect of bee propolis supplementation on insulin resistance indices in patients with type 2 diabetes: a randomized double-blind clinical trial; 2017. Samadi N, Khosravi HM, Rahmanian M, Shahi MA. Effect of bee propolis supplementation on insulin resistance indices in patients with type 2 diabetes: a randomized double-blind clinical trial; 2017.
26.
go back to reference Lee KN, Lee OY. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome. World J Gastroenterol. 2014;20(27):8886. Lee KN, Lee OY. Intestinal microbiota in pathophysiology and management of irritable bowel syndrome. World J Gastroenterol. 2014;20(27):8886.
27.
go back to reference Mahan LK, Raymond JL. Krause's food & the nutrition care process-e-book. St. Louis: Elsevier Health Sciences; 2016. Mahan LK, Raymond JL. Krause's food & the nutrition care process-e-book. St. Louis: Elsevier Health Sciences; 2016.
28.
go back to reference Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95. Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381–95.
29.
go back to reference Moghaddam MB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J. 2012;18(8):1073–80. Moghaddam MB, Aghdam FB, Jafarabadi MA, Allahverdipour H, Nikookheslat SD, Safarpour S. The Iranian Version of International Physical Activity Questionnaire (IPAQ) in Iran: content and construct validity, factor structure, internal consistency and stability. World Appl Sci J. 2012;18(8):1073–80.
30.
go back to reference Sjostrom M, Ainsworth B, Bauman A, Bull F, Hamilton-Craig C, Sallis J. Guidelines for data processing analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms; 2005. Sjostrom M, Ainsworth B, Bauman A, Bull F, Hamilton-Craig C, Sallis J. Guidelines for data processing analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms; 2005.
31.
go back to reference Beck AT, Steer R. Beck anxiety inventory (BAI). Überblick über Reliabilitäts-und Validitätsbefunde von klinischen und außerklinischen Selbst-und Fremdbeurteilungsverfahren; 1988. p. 7. Beck AT, Steer R. Beck anxiety inventory (BAI). Überblick über Reliabilitäts-und Validitätsbefunde von klinischen und außerklinischen Selbst-und Fremdbeurteilungsverfahren; 1988. p. 7.
32.
go back to reference Rafiei M, Seifi A. An investigation into the reliability and validity of beck anxiety inventory among the university students. Iran J Psychiatry Clin Psychol. 2013;7(27):37–46. Rafiei M, Seifi A. An investigation into the reliability and validity of beck anxiety inventory among the university students. Iran J Psychiatry Clin Psychol. 2013;7(27):37–46.
33.
go back to reference Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J TUMS Publ. 2008;66(2):136–40. Kaviani H, Mousavi A. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J TUMS Publ. 2008;66(2):136–40.
34.
go back to reference A'hern R. Sample size tables for exact single-stage phase II designs. Stat Med. 2001;20(6):859–66.PubMed A'hern R. Sample size tables for exact single-stage phase II designs. Stat Med. 2001;20(6):859–66.PubMed
35.
go back to reference Baştürk A, Artan R, Yılmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: a randomized controlled trial. Turk J Gastroenterol. 2016;27(5):439–43.PubMed Baştürk A, Artan R, Yılmaz A. Efficacy of synbiotic, probiotic, and prebiotic treatments for irritable bowel syndrome in children: a randomized controlled trial. Turk J Gastroenterol. 2016;27(5):439–43.PubMed
36.
go back to reference Nair AB, Jacob S. A simple practice guide for dose conversion between animals and human. J Basic Clin Pharm. 2016;7(2):27.PubMedPubMedCentral Nair AB, Jacob S. A simple practice guide for dose conversion between animals and human. J Basic Clin Pharm. 2016;7(2):27.PubMedPubMedCentral
37.
go back to reference Carrier M, Abou-Nassar K, Mallick R, Tagalakis V, Shivakumar S, Schattner A, et al. Apixaban to prevent venous thromboembolism in patients with cancer. N Engl J Med. 2019;380(8):711–9.PubMed Carrier M, Abou-Nassar K, Mallick R, Tagalakis V, Shivakumar S, Schattner A, et al. Apixaban to prevent venous thromboembolism in patients with cancer. N Engl J Med. 2019;380(8):711–9.PubMed
38.
go back to reference Enders CK. A primer on maximum likelihood algorithms available for use with missing data. Struct Equ Model. 2001;8(1):128–41. Enders CK. A primer on maximum likelihood algorithms available for use with missing data. Struct Equ Model. 2001;8(1):128–41.
39.
go back to reference Simone-Finstrom M, Borba R, Wilson M, Spivak M. Propolis counteracts some threats to honey bee health. Insects. 2017;8(2):46.PubMedCentral Simone-Finstrom M, Borba R, Wilson M, Spivak M. Propolis counteracts some threats to honey bee health. Insects. 2017;8(2):46.PubMedCentral
40.
go back to reference Batista LLV, Campesatto EA, Assis MLB, Barbosa APF, Grillo LAM, Dornelas CB. Comparative study of topical green and red propolis in the repair of wounds induced in rats. Rev Col Bras Cir. 2012;39(6):515–20.PubMed Batista LLV, Campesatto EA, Assis MLB, Barbosa APF, Grillo LAM, Dornelas CB. Comparative study of topical green and red propolis in the repair of wounds induced in rats. Rev Col Bras Cir. 2012;39(6):515–20.PubMed
41.
go back to reference Silva LM, Souza PD, Jaouni SKA, Harakeh S, Golbabapour S, de Andrade SF. Propolis and its potential to treat gastrointestinal disorders. Evid Based Complement Alternat Med. 2018;2018:2035820.PubMedPubMedCentral Silva LM, Souza PD, Jaouni SKA, Harakeh S, Golbabapour S, de Andrade SF. Propolis and its potential to treat gastrointestinal disorders. Evid Based Complement Alternat Med. 2018;2018:2035820.PubMedPubMedCentral
43.
go back to reference Niedzielska I, Puszczewicz Z, Mertas A, Niedzielski D, Różanowski B, Baron S, et al. The influence of ethanolic extract of Brazilian green propolis gel on hygiene and oral microbiota in patients after mandible fractures. Biomed Res Int. 2016;2016:9190814.PubMedPubMedCentral Niedzielska I, Puszczewicz Z, Mertas A, Niedzielski D, Różanowski B, Baron S, et al. The influence of ethanolic extract of Brazilian green propolis gel on hygiene and oral microbiota in patients after mandible fractures. Biomed Res Int. 2016;2016:9190814.PubMedPubMedCentral
44.
go back to reference Aslan A, Temiz M, Atik E, Polat G, Sahinler N, Besirov E, et al. Effectiveness of mesalamine and propolis in experimental colitis. Adv Ther. 2007;24(5):1085–97.PubMed Aslan A, Temiz M, Atik E, Polat G, Sahinler N, Besirov E, et al. Effectiveness of mesalamine and propolis in experimental colitis. Adv Ther. 2007;24(5):1085–97.PubMed
45.
go back to reference Abikim G, Yimit R, Tursunay A, Aerziguli T, Mutallip A. Effect of essential oils extracted from Xingjiang propolis on cell proliferation, cell cycle progression and apoptosis in human colorectal cancer cell line HTC-116. Shijie Huaren Xiaohua Zazhi. 2011;19:1469–75. Abikim G, Yimit R, Tursunay A, Aerziguli T, Mutallip A. Effect of essential oils extracted from Xingjiang propolis on cell proliferation, cell cycle progression and apoptosis in human colorectal cancer cell line HTC-116. Shijie Huaren Xiaohua Zazhi. 2011;19:1469–75.
46.
go back to reference Kassaian N, Aminorroaya A, Feizi A, Jafari P, Amini M. The effects of probiotic and synbiotic supplementation on metabolic syndrome indices in adults at risk of type 2 diabetes: study protocol for a randomized controlled trial. Trials. 2017;18(1):148.PubMedPubMedCentral Kassaian N, Aminorroaya A, Feizi A, Jafari P, Amini M. The effects of probiotic and synbiotic supplementation on metabolic syndrome indices in adults at risk of type 2 diabetes: study protocol for a randomized controlled trial. Trials. 2017;18(1):148.PubMedPubMedCentral
47.
48.
go back to reference Khademolhosseini F, Mehrabani D, Nejabat M, Beheshti M, Heydari ST, Mirahmadizadeh A, et al. Irritable bowel syndrome in adults over 35 years in Shiraz, southern Iran: prevalence and associated factors. J Res Med Sci. 2011;16(2):200.PubMedPubMedCentral Khademolhosseini F, Mehrabani D, Nejabat M, Beheshti M, Heydari ST, Mirahmadizadeh A, et al. Irritable bowel syndrome in adults over 35 years in Shiraz, southern Iran: prevalence and associated factors. J Res Med Sci. 2011;16(2):200.PubMedPubMedCentral
Metadata
Title
Does propolis affect the quality of life and complications in subjects with irritable bowel syndrome (diagnosed with Rome IV criteria)? A study protocol of the randomized, double-blinded, placebo-controlled clinical trial
Authors
Mahsa Miryan
Pezhman Alavinejad
Mohammadreza Abbaspour
Davood Soleimani
Alireza Ostadrahimi
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Trials / Issue 1/2020
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-020-04615-5

Other articles of this Issue 1/2020

Trials 1/2020 Go to the issue