Many patients with ulcerative colitis still experience diarrhoea despite being told by their doctor that their disease is under control (in remission). MODULATE aims to discover what treatments we should be offering this group of people, in order to improve their symptoms and quality of life.
When some people with UC, continue to experience difficult, chronic diarrhoea even when they display no evidence of inflammatory activity, this can have a huge physical and emotional impact on them. However, we don’t currently know how best to treat these people.
A potential approach may be to use existing treatments that work in other conditions for example, Irritable Bowel Syndrome (IBS). There are important differences between IBS and UC. However, it’s possible that some diarrhoea treatments may work for both conditions.
One of those treatments is a special diet known as the low FODMAP diet. Several drugs are also used to treat diarrhoea in IBS, including low-dose tricyclic antidepressants (TCAs), such as amitriptyline, the anti-sickness drug ondansetron, and the anti-diarrhoeal drug, loperamide. All of these treatments are known to slow down the flow of digested food down the gut, improving diarrhoea and other related symptoms.
MODULATE is the first study to explore whether these treatments are effective in relieving diarrhoea symptoms in people with stable UC, as there is currently no standard treatment for managing diarrhoea in this group of people. This study has the added benefit that most participants will be able to take part remotely. We hope that the results will lead to an improvement in quality of life for those affected.