MRI assessment in newly diagnosed coeliac disease and following gluten-free diet treatment (MARCO)
22nd May 2015 - ongoing
Status: In Recruitment
Coeliac disease (CD) is an autoimmune disease induced in genetically susceptible individuals after ingestion of gluten and affects 1 in 100 people. The only treatment is a strict gluten-free diet for life. The gold standard diagnostic test is a duodenal biopsy. The small bowel mucosa is primarily affected resulting in progressive degrees of villous inflammation and destruction.
Loss of villi, which absorb fluid, hypertophy of crypts, which produce fluid, and slower small bowel transit result in fluid excess in the small bowel lumen. Until recently it has been difficult to study bowel fluid distribution without invasive techniques such as intubation, which may disturb physiology. Pilot data from a study using a new Magnetic Resonance Imaging (MRI) technique at the University of Nottingham showed that small bowel water content was increased in untreated coeliac disease compared to healthy volunteers.
Based on our pilot data, this observational study in 36 newly diagnosed coeliac disease patients before and after a gluten-free diet study aims to test the main hypotheses that
1. Before treatment, the water content of the small bowel will be increased compared to the control population.
2. After 12 months on a gluten-free diet the small bowel water content will revert to normal values.
The study will also explore the association, if any, between small bowel water content and colonic volumes on
adults newly diagnosed with CD and their gastrointestinal symptoms, Marsh grading of duodenal biopsies, fasting breath hydrogen, serology values, faecal microbiota and short chain fatty
Exploration of the relationship between the mode of coeliac presentation with objective MRI bowel parameters will help improve our understanding of contemporary coeliac disease. Assessment of changes in small bowel water volume and colon organ volumes with gluten free diet may help explain the mechanisms driving gastrointestinal symptoms and their persistence.
|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…|
|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…|