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CompletedNCT03470181Updated Feb 27, 2020

Applying Nutrient Drink Test in Understanding Pathophysiology of CVS

An observational study in Cyclic Vomiting Syndrome, sponsored by The Cleveland Clinic. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-02-27.

Sponsored by The Cleveland Clinic · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
24
Ages
18 Years and older
Sex
All
01

Study summary

Cyclic vomiting syndrome is a disorder characterized by nausea and vomiting, separated by periods without any symptoms. There is very little research on this field at this point and most doctors do not fully understand the disorder. The goal of this study is to assess how the stomach empties food. Participants will be asked to participate in this study because either (a) they have been diagnosed and/or treated for cyclic vomiting syndrome in the past, or (b) they are physically healthy. The study seeks to compare how a healthy person's stomach empties to how the stomach of someone with cyclic vomiting disorder empties.

Read the detailed description

Up to 14% of unexplained vomiting in adults is attributed to an under recognized and often misdiagnosed disorder termed cyclic vomiting syndrome (CVS). As CVS is better understood, gastroenterologists are increasingly recognizing the importance of timely diagnosis and early management for this chronic and debilitating disorder. Currently, the only gold standard diagnostic strategy involves evaluating clinical criteria set by the Rome Foundation, such as vomiting frequency and duration of episodes. Outside of these subjective criteria, no definitive and objective diagnostic strategy for cyclic vomiting syndrome exists.

Developing diagnostic strategies has been difficult given the exact etiology of CVS is still unknown. One physiologic theory includes rapid gastric emptying (GE)-or a dumping-like syndrome related to impaired gastric accommodation. A retrospective analysis observed rapid gastric emptying by standard 4-hour scintigraphic gastric emptying study in 80% of subjects, suggesting a relationship with CVS and rapid GE. In turn, rapid emptying has been hypothesized to relate with abnormal gastric accommodation - the reflex allowing storage of food through increased fundic volume. This physiologic abnormality can be readily and easily measured using non-invasive tools, but have never been tested in CVS. To explore this further, we aim to determine if CVS patients have abnormal gastric accommodation measured by nutrient drink test.

02

Conditions studied

  • Cyclic Vomiting Syndrome

Keywords

  • Chronic nausea, intermittent vomiting, impaired accommodation
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

The study seeks to enroll adult patients diagnosed with Cyclic Vomiting Syndrome, as well as healthy controls

Inclusion criteria

  • Diagnosed with Cyclic Vomiting (or Healthy Volunteer)
  • Age 18 or greater

Exclusion criteria

Exclusion Criteria:

  • Age Under 18
  • History of gastric surgery
  • History of marijuana use
  • History of Gastroparesis
  • History of Diabetes mellitus II
  • Upper endoscopy with known obstructive gastric disease
  • Current pregnancy or lactation
  • Active inflammatory bowel disease (Crohn's disease, Ulcerative colitis)
  • Severe renal disease (GFR \<15/dialysis dependent)
  • Active malignancy (diagnosed in last 5 years)
  • Allergy/intolerance to liquid Ensure®
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
24 participants (actual)
Patient registry
No

Groups and cohorts

  • Participants with Diagnosed CVS

    This cohort will consist of 15 current patients previously diagnosed with Cyclic Vomiting Syndrome.

    Dietary Supplement: Ensure

  • Healthy Volunteers

    This cohort will consist of 15 healthy volunteers, with no history of Cyclic Vomiting.

    Dietary Supplement: Ensure

Interventions

  • Dietary supplementEnsure

    Participants will perform a Nutrient Drink Test. This consists of drinking 125mL of liquid Ensure four times, at five-minute intervals.

05

What researchers measure

Primary outcomes

  1. Maximum tolerated volume

    The amount of nutrient drink consumed before the participant reports feelings of unbearable fullness.

    Time frame: Within 30 minutes of beginning the test.

Secondary outcomes

  1. Total Aggregate Symptom Score

    Participant-Reported impressions of fullness, bloating, or abdominal pain, measures on 100mm visual analog scale

    Time frame: Within 30 minutes of the beginning of the test

06

Study locations

1 site
  • Cleveland Clinic
    Cleveland, Ohio 44195, United States
07

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03470181
Lead sponsor
The Cleveland Clinic
Responsible party
Scott Gabbard, MD (Staff, The Cleveland Clinic) — Principal investigator
First posted
Mar 19, 2018
Start date
Feb 1, 2018
Primary completion
May 29, 2018
Completion
May 29, 2018
Last update
Feb 27, 2020

Study contacts

Scott Gabbard, MD
principal investigator · The Cleveland Clinic

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Feb 2020. You cannot join it, but the record below documents what was studied.

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