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Functional Bowel DisorderNCT06338189

The 5Ad Diet for Functional Bowel Disorders

A study testing The 5Ad Diet and The Low FODMAP Diet in people with Functional Bowel Disorder and Irritable Bowel Syndrome, run by University of Suffolk at 1 site in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this randomised controlled trial (RCT) is to compare the efficacy of the newly developed 5Ad diet against the widely researched low fermentable oligo-, di-, monosaccharide and polyols (FODMAP) diet in reducing gastrointestinal symptoms associated with functional bowel disorders/food intolerances. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
The 5Ad Diet and The Low FODMAP Diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
52 participants
Where
1 siteUnited Kingdom
Study dates
8 May 2022to 1 Apr 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Individuals are eligible for the study if all of the following criteria are met:
  • Suffers chronically from either constipation, diarrhoea, or an alternation of both, bloating, flatulence or abdominal pain, incomplete defecation, straining and bowel urgency.
  • Symptoms must be present for ≥ 2 times per week, with symptom onset occurring at least 3 months prior to participation.
  • Participants taking prescribed medications which may affect bowel function are included only if the intake is maintained throughout the entire intervention period.

Who cannot join

  • Individuals are excluded from the study if any of the following criteria are met:
  • Pregnant.
  • Known underlying pathology (e.g., Crohn's disease, ulcerative colitis, celiac disease).
  • History of abdominal/gastrointestinal surgery within 1 year prior to participation.
  • History of antibiotic use in the last 6 weeks prior to participation.
  • Allergic to the foods specified in both the 5Ad diet and the low FODMAP diet.

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • University of Suffolk

    Ipswich, Suffolk, IP4 1QJ

Other trials in United Kingdom

About this study

Official title: The 5Ad Diet for Functional Bowel Disorders: A Randomised Controlled Trial Against the Low FODMAP Diet

The goal of this randomised controlled trial (RCT) is to compare the efficacy of the newly developed 5Ad diet against the widely researched low fermentable oligo-, di-, monosaccharide and polyols (FODMAP) diet in reducing gastrointestinal symptoms associated with functional bowel disorders/food intolerances.

The primary aims of this RCT are to determine:

Read more
  • Whether the 5Ad diet is at least as effective as the low FODMAP diet in reducing gastrointestinal symptoms associated with FBDs/food intolerances.
  • Whether either the 5Ad diet or the low FODMAP diet are effective in reducing mental and physical fatigue.

To achieve the above aims, an RCT will be conducted with the 5Ad diet in one arm vs the active phase of the low FODMAP diet in the other arm, in a cross-over design with a 7 days washout phase in between. Both dietary protocols will be followed by each participant for 7 days.

Researchers will compare the results from the 2 dietary protocols in order to ascertain the superiority of one over the other in regards to 6 gastrointestinal symptoms (abdominal pain, bloating, flatulence, bowel urgency, straining and incomplete defecation), stool form and frequency of defecation.

Read the detailed description

Functional Bowel Disorders (FBDs) are characterised by chronic gastrointestinal symptoms including abdominal pain, constipation, bloating, diarrhoea, alternating abdominal symptoms, and irregular frequency of bowel movements among others in the absence of any intestinal abnormality. The prevalence of FBDs ranges from 15 - 20% worldwide, with remarkable economic burden on health systems and significant impact on the quality of life of sufferers. It is estimated that between 60% - 89% of individuals that suffer from FBDs find that foods exacerbate their symptoms. Therefore, dietary therapies are frequently implemented to assist with symptom relief in these individuals.

Although the low FODMAP diet is the most commonly followed diet for the treatment of FBDs, there are concerns regarding it's complexity, restrictiveness, nutritional adequacy, and effectiveness. Therefore, the 5Ad diet was designed to fill a gap in the existing research and to overcome the limitations associated with existing dietary approaches.

Preliminary findings from the first study in 2019 suggested that the 5Ad diet might be a promising universal approach for varying forms and severities of FBDs. Therefore, an RCT is needed to substantiate these previous results. Thus, this RCT aims to determine whether the 5Ad diet is at least as effective as the low FODMAP diet in reducing gastrointestinal symptoms associated with FBDs/food intolerances.

Being tested
The 5Ad Diet, The Low FODMAP Diet
Keywords
The 5Ad Diet, The Low FODMAP Diet, Irritable Bowel Syndrome, Functional Constipation, Functional Diarrhoea, Functional Bloating
Medical subject headings
Irritable Bowel Syndrome, Food Intolerance

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • The 5Ad DietOther

    Participants are to follow the 5Ad diet.

  • The Low FODMAP DietOther

    Participants are to follow the active phase of the Low FODMAP diet.

Study groups in NCT06338189
Study groupRoleWhat they receive
The 5Ad DietActive comparatorParticipants are required to follow the 5Ad diet for 7 days, followed by a washout phase for 7 days, before crossing over to the active phase of the low FODMAP diet for 7 days.
Receives: Other: The 5Ad Diet; Other: The Low FODMAP Diet
The Low FODMAP DietActive comparatorParticipants are required to follow the active phase of the low FODMAP diet for 7 days, followed by a washout phase for 7 days, before crossing over to the 5Ad diet for 7 days.
Receives: Other: The 5Ad Diet; Other: The Low FODMAP Diet

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Abdominal Pain

    Abdominal pain will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  2. Abdominal Bloating

    Abdominal bloating will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  3. Flatulence

    Flatulence will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  4. Bowel Urgency

    Bowel urgency will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  5. Straining

    Straining will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  6. Incomplete Defecation

    Incomplete defection will be recorded daily in a symptom diary and measured using a 4 point Likert-type scale, coded from 0 - 10 for conversion into continuous variables (None = 0; Mild = 1 - 3; Moderate = 4 - 6 ; Severe = 7 - 10).

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  7. Stool Form

    Stool form will be measured using the Bristol Stool Form Scale. Type 1 - Separate hard lumps, like nuts (hard to pass), Type 2 - Sausage shaped, but lumpy, Type 3 - Like a sausage but with cracks on its surface, Type 4 - Like a sausage or snake, smooth and soft, Type 5 - Soft blobs with clear cut edges (passed easily), Type 6 - Fluffy pieces with ragged edges, a mushy stool, and Type 7 - Watery, no solid pieces, entirely liquid. Stool Types 1 and 2 are associated with constipation, while stool Types 5 - 7 are associated with diarrhoea. Stool Types 3 and 4 are considered normal stools.

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

  8. Frequency of defecation

    Frequency of defecation will be recorded daily in a symptom diary.

    Measured: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)

Secondary outcomes (3)
  1. Fatigue

    Fatigue will be recorded and measured using the Fatigue Assessment Scale (FAS) (Michielsen et al., 2003), using a 5 point Likert-type scale, coded from 1 - 5 for conversion into continuous variables (None = 1; Sometimes = 2; Regularly = 3; Often = 4; Always = 5). Question 1 - I am bothered by fatigue; Question 2 - I get tired very quickly; Question 3 - I don't do much during the day; Question 4 - I have enough energy for everyday life; Question 5 - Physically, I feel exhausted; Question 6 - I have problems starting things; Question 7 - I have problems thinking clearly; Question 8 - I feel no desire to do anything; Question 9 - Mentally, I feel exhausted and Question 10 - When I am doing something, I can concentrate quite well. Question 4 and 10 are to be reverse scored. Total scores can range from 10, indicating the lowest level of fatigue, to 50, denoting the highest.

    Measured: Assessed on the last day of both dietary protocols (Day 7 of each dietary protocol)

  2. Mental Fatigue

    Mental fatigue will be measured using the Fatigue Assessment Scale (FAS), using a 5 point Likert-type scale, coded from 1 - 5 for conversion into continuous variables (None = 1; Sometimes = 2; Regularly = 3; Often = 4; Always = 5). Only questions 6 - 10 will be used to calculate the mental fatigue score. Question 6 - I have problems starting things; Question 7 - I have problems thinking clearly; Question 8 - I feel no desire to do anything; Question 9 - Mentally, I feel exhausted and Question 10 - When I am doing something, I can concentrate quite well. Question 10 is to be reverse scored. Total scores can range from 5, indicating the lowest level of fatigue, to 25, denoting the highest.

    Measured: Assessed on the last day of both dietary protocols (Day 7 of each dietary protocol)

  3. Physical Fatigue

    Physical fatigue will be measured using the Fatigue Assessment Scale (FAS), using a 5 point Likert-type scale, coded from 1 - 5 for conversion into continuous variables (None = 1; Sometimes = 2; Regularly = 3; Often = 4; Always = 5). Only questions 1 - 5 will be used to calculate the mental fatigue score. Question 1 - I am bothered by fatigue; Question 2 - I get tired very quickly; Question 3 - I don't do much during the day; Question 4 - I have enough energy for everyday life; Question 5 - Physically, I feel exhausted. Question 4 is to be reverse scored. Total scores can range from 5, indicating the lowest level of fatigue, to 25, denoting the highest.

    Measured: Assessed on the last day of both dietary protocols (Day 7 of each dietary protocol)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Mar 2024
  2. Study start8 May 2022
  3. Primary completion1 Apr 2025
  4. Study completion1 Apr 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
52 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06338189
Sponsor's protocol ID
USuffolk
Status last verified
Nov 2025
First submitted
15 Mar 2024
Last updated
24 Nov 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Ibrahim F, Stribling P. A 5Ad Dietary Protocol for Functional Bowel Disorders. Nutrients. 2019 Aug 17;11(8):1938. doi: 10.3390/nu11081938.

    PubMed 31426496
  • Ibrahim F, Stribling P. Reply to "A Gluten Reduction Is the Patients' Choice for a Dietary 'Bottom Up' Approach in IBS-A Comment on "A 5Ad Dietary Protocol for Functional Bowel Disorders" Nutrients 2019, 11, 1938". Nutrients. 2020 Jan 3;12(1):140. doi: 10.3390/nu12010140.

    PubMed 31947828
  • Gibson PR, Shepherd SJ. Personal view: food for thought--western lifestyle and susceptibility to Crohn's disease. The FODMAP hypothesis. Aliment Pharmacol Ther. 2005 Jun 15;21(12):1399-409. doi: 10.1111/j.1365-2036.2005.02506.x.

    PubMed 15948806
  • Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol. 1997 Sep;32(9):920-4. doi: 10.3109/00365529709011203.

    PubMed 9299672
  • Michielsen HJ, De Vries J, Van Heck GL. Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. J Psychosom Res. 2003 Apr;54(4):345-52. doi: 10.1016/s0022-3999(02)00392-6.

    PubMed 12670612

Questions about this trial

What is this clinical trial studying?

A study testing The 5Ad Diet and The Low FODMAP Diet in people with Functional Bowel Disorder and Irritable Bowel Syndrome, run by University of Suffolk at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 24 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Abdominal Pain (time frame: Assessed daily throughout both dietary protocols (7 days for each dietary protocol)). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06338189, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 24 Nov 2025.

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