Reclassifying Constipation Using Magnetic Resonance Imaging Combined With High Resolution Manometry: A Validation Study And Double-Blind Crossover Trial (RECLAIM Study)

1st December 2016 - ongoing

Status: In Recruitment

Specialism: Lower GI, Functional Bowel Disorder, Constipation.

Team: Professor Robin SpillerDr Gordon MoranDr Victoria Wilkinson-SmithDr Luca MarcianiDr Caroline HoadDr Maura CorsettiProfessor Penny Gowland.

Constipation is a common condition in which an individual suffers with hard stools which are infrequent and difficult to pass. It is poorly understood and treatment is often unsatisfactory. Many patients also experience pain whilst others do not but it is unclear why. It is believed that the pain arises from contractions in the colon, the lower part of the intestines. Some patients with constipation have weak colonic contraction but surprisingly some, particularly those with a lot of pain have strong contractions which are poorly coordinated. These patients all suffer from constipation but would are likely to need very different treatments. At present we cannot identify what type of abnormality of colonic contractions each individual patient suffers from and so are unable to give them the best treatment. This study will take advantage of two new techniques which have been recently developed. Magnetic Resonance Imaging (MRI) which will allow us to see the contractions of the colon in response to a dose of the laxative Moviprep which increases the flow of fluid into the proximal part of the colon and High Resolution Manometry (HRM) which measures the power and direction of the contraction in much more detail than ever before using a pressure sensing catheter placed into the bowel. Using these 2 techniques we will identify the pattern of contractions in 80 patients with constipation and 40 healthy controls. We will then enter them into a controlled trial of either a drug which stimulates contractions or one which inhibits contraction. We anticipate that the pattern of contractions identified by the non-invasive MRI technique will predict which treatment will reduce their symptoms most as effectively as the more invasive HRM. If this is the case then our MRI test of colonic responsiveness could become widely used in routine clinical practice.

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People
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professor-robin-spiller Professor Robin Spiller Robin's main interest is in the pathophysiology of functional GI diseases, particularly focusing on the role of infection and inflammation and alterations in serotonin metabolism in the irritable bowel syndrome. He has twice edited the British Society of…
dr-gordon-moran Dr Gordon Moran Dr Moran did his undergraduate medical training at University of Malta Medical School and was awarded an MD in 1999. He completed his basic postgraduate training at St. Luke's Hospital in Malta and gained membership of the Royal College of Physicians of…
Dr Victoria Wilkinson-Smith
dr-luca-marciani Dr Luca Marciani I graduated in Physics at the University of Genoa in Italy. I then worked in Milan and London before joining the University of Nottingham, where I was awarded my PhD in Physics. Following a series of multi-disciplinary research contracts and Fellowships…
caroline-hoad Dr Caroline Hoad
Dr Maura Corsetti Dr Maura Corsetti is a Clinical Associate Professor in Gastroenterology at the University of Nottingham. She obtained her Specialization (2000) and PhD (2004) at the "Universita' degli Studi di Milano", Italy. During her PhD she worked for two years…
professor-penny-gowland Professor Penny Gowland Developing quantitative MRI for biomedical applications. I am particularly interested in exploiting the capabilities of functional and anatomical ultra-high field MRI in neuroscience, in using the increased contrast to noise ratio available at ultrahigh…
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