Validation of Magnetic Resonance Imaging to characterise gastrointestinal physiology, gut luminal content and its interaction with colonic microbiota in patients with chronic constipation (MIMIC)

1st April 2014

Status: Ended

Specialism: Lower GI.

Team: Professor Robin Spiller.

Constipation affects people all over the world. Around 1 in 2 patients with chronic constipation are not satisfied with their treatment so improved understanding of how laxatives work would be welcome.

In the past investigating bowel function has involved invasive procedures or using X-rays which can be harmful in large doses. In this study we will look inside the bowel with Magnetic Resonance Imaging (MRI), a technique that does not use X-rays and is safe to repeat. We will also analyse bacteria in the stool. We want to look at the bowel of constipated people at rest, and how the bowel responds to a stimulus.

Ispaghula is a bean husk that is sold on the high street as a dietary supplement. Many people take it for its laxative properties. Past studies have shown that it speeds up the passage of matter through the bowel and that it increases stool bulk. Our pilot data in healthy volunteers has shown that it increases water in the colon. It may also change the bacteria present in the bowel, leading to increases in bowel activity.

We will recruit adults with chronic constipation and compare the effects of a week taking Ispaghula and a week taking a placebo. Screening time and recovery time between treatment periods mean that each participant will be in the study for 10 weeks.

The study is taking place at the NIHR Nottingham Digestive Diseases Biomedical Research Unit and the Sir Peter Mansfield Imaging Centre of the University of Nottingham, in collaboration with the University of Helsinki who will analyse the bacteria. It is a collaborative study between the University of Nottingham and Ironwood Pharmaceuticals, a company with an interest in understanding how laxatives work.

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