Gastrointestinal permeability change around bariatric surgery V1.0
Research type
Research Study
Full title
The effect of sleeve gastrectomy and associated dietary change on permeability of the gastrointestinal tract.
IRAS ID
288684
Contact name
Adam Frampton
Contact email
Sponsor organisation
University of Surrey
Clinicaltrials.gov Identifier
SPON 2021 08 FHMS, University of Surrey Research and Innovation Services
Duration of Study in the UK
1 years, 0 months, 7 days
Research summary
Bariatric surgery is established as an effective treatment for obesity that consistently results in significant weight loss and an improvement in the co-morbidities associated with metabolic disease, such as hypertension, type two diabetes and fatty liver. With an increasing incidence of obesity worldwide, the total number of bariatric procedures performed looks set to increase. UK registries report the majority of patients undergo sleeve gastrectomy (42.5% in 2018). The mechanism of action of surgery, thought to involve gastrointestinal permeability (gut wall “leakiness”), the microbiome, diet, anatomical and neuro-entero-hormonal change, is poorly understood. Gut permeability has been identified as a critical component of the metabolic change that follows surgery, supported by non-bariatric studies showing that intestinal permeability is associated with obesity, is increased in diabetics and persists even when BMI is controlled. There are a small number of studies around permeability after bariatric surgery, and the published literature shows conflicting results. By studying consenting adult patients undergoing surgery at St Richard's Hospital, we aim to increase understanding of permeability before and after sleeve gastrectomy, and investigate further any association with fatty liver disease and colonic change, through analysis of urinary permeability samples, diet, liver biopsy and markers in blood and urinary samples. Sampling will be in addition to routine care samples, but taken at the same time, in order to minimise patient discomfort and inconvenience. Each patient will collect urinary permeability samples at home, the day before a routine clinical interaction, so there are no unnecessary visits to hospital to return the urine samples. Sampling will be repeated four times over a total of 12 months of study, and requires no deviation from standard care.
REC name
South Central - Hampshire A Research Ethics Committee
REC reference
21/SC/0323
Date of REC Opinion
16 Nov 2021
REC opinion
Further Information Favourable Opinion