Bowel adaption and the gut microbiome in Intestinal Failure
Research type
Research Study
Full title
Gut microbial co-metabolism and adaptation in short bowel syndrome
IRAS ID
245933
Contact name
Alan Warnes
Contact email
Sponsor organisation
London North West University Healthcare NHS Trust
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Short bowel syndrome (SBS) occurs after a surgical emergency where significant surgical resection of bowel is required. It can arise as a result of a failure of blood supply to the bowel, such as through blockage of blood vessels, or a twist in the bowel itself restricting its blood supply. It may occur as a result of a surgical complication or due to specific inflammatory disease processes such as Crohn’s disease. It is a catastrophic surgical condition with a high associated morbidity and mortality. These patients often require significant nutritional support such as parenteral nutrition in the long term, leading to frequent hospital visits, poor quality of life and reduced survival.
Intestinal adaption is a natural compensatory process that occurs following extensive intestinal resection, whereby structural and functional changes in the intestine can improve nutrient and fluid absorption in the remnant bowel. It has previously been shown that small bowel adaption can occur slowly in the event of SBS, and that restoring continuity by joining the remaining small bowel to the remaining colon significantly reduces the requirement for home parenteral nutrition.
Recent advances in our understanding of intestinal health have highlighted the importance of the microbes that live in our gut and their interaction with our host immune system in a series of metabolic processes to maintain intestinal health and nutritional intake. However little is known of the microbial composition and changes that may occur in patients with shortened bowel length and the effect this may have on intestinal health.
The aim of this study is to gain an understanding of the microbial diversity in different parts of the intestine in short bowel syndrome, how they differ to normal controls, assess how these change over time, and how they change following restoration of continuity of bowel (if patient previously had a stoma) We will also look at the end products of cellular processes in the blood, stool and tissue of patients with small bowel in order to determine the factors that may play a role in promoting which patients are more likely to achieve bowel adaption to reduce reliance on artificial feeding.
REC name
Wales REC 6
REC reference
18/WA/0414
Date of REC Opinion
22 Jan 2019
REC opinion
Further Information Favourable Opinion