Exploring small bowel feeding intolerance in dysmotility v1.0
Research type
Research Study
Full title
Exploring intolerance of small bowel feeding in severe gastrointestinal dysmotility: a feasibility study.
IRAS ID
331384
Contact name
Peter Paine
Contact email
Sponsor organisation
Northern Care Alliance NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
The diagnosis of severe gastrointestinal dysmotility (a disorder of the muscles of the small bowel and other parts of the gut) is challenging. Some patients who cannot eat enough to maintain nutrition experience difficulties with tube feeding into their small bowel due to the symptoms this produces, especially pain. This can occur with very small amounts of feed, severely limiting feeding rates and can lead to problems with supporting nutrition. Patients with this problem then often receive feeding into their veins, which is higher risk than tube feeding and can be associated with poorer quality of life.
The inability to tolerate tube feeding at low rates is one of the features used to help make a diagnosis of severe gastrointestinal dysmotility but it is poorly understood why this occurs. It is difficult to explain why very small amounts of feed given very slowly causes severe pain. Sometimes psychological factors limiting tolerance may be just as important as physical ones.
A novel way of exploring intolerance of tube feeding in a clinical setting was previously described in a child. This was done by using two feed pumps instead of the usual one pump, (but still only one feeding tube). The two pumps were used to safely vary the rate and type of feed given. Both the patient and team were unaware of the rates delivered. The rates ranged from very slow up to the normal speed given in standard care.
At the end of the study the patient and the team were made aware of rates used which provided important clinical information, helping the patient’s holistic care.
This study would aim to see whether the approach is also feasible and acceptable in adults, to guide their clinical care, and to help the patient and clinicians better understand their symptoms.REC name
North West - Liverpool Central Research Ethics Committee
REC reference
23/NW/0364
Date of REC Opinion
9 Jan 2024
REC opinion
Further Information Favourable Opinion