Pouchitis and PSC: a role for bile acids?
Research type
Research Study
Full title
Pouchitis and PSC: a role for bile acids?
IRAS ID
161822
Contact name
Bu'Hussain Hayee
Contact email
Sponsor organisation
R&D Department, King's College Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 7 months, 19 days
Research summary
Ulcerative colitis (UC) is a form of chronic inflammatory bowel disease, characterised by large bowel wall inflammation that leads to episodes of diarrhoea, bleeding and urgency that can on many occasions require surgery to control. Primary sclerosing cholangitis (PSC) is a chronic progressive liver disease that leads most patients to liver transplantion as it is incurable.
Up to 80% of patients with PSC have also some form of UC. Previous studies have reported on the increasing severity of UC after liver transplantation for PSC- often necessitating the surgical removal of the large bowel. A formation of a small bowel pouch is a common surgical option for such patients as it provides bowel frequency control. Intriguingly the development of chronic inflammation in the pouch (pouchitis) is doubled in patients with PSC compared to those without and reaches almost 80% in those with a liver transplant.
Bile acids, excreted through bile into the bowel helping the absorption of food, have been shown to aggravate the bowel inflammation associated with UC. Bile acids can be deranged also in the context of PSC as they originate from the liver. We hypothesise that the composition of bile acids in the pouch is key to the increased frequency of pouchitis in patients with PSC.
To test this hypothesis we plan to recruit relevant patients who attend the endoscopy department at King's College Hospital for their endoscopic pouch evaluation. Fluid from the distal bowel and pouch will be taken for bile salt analysis. Bowel lining biopsies will also be taken for assessment of inflammation and relevant mediators.
If our hypothesis is confirmed the results of this study will be used to support a larger application for an interventional study.REC name
London - Riverside Research Ethics Committee
REC reference
14/LO/2118
Date of REC Opinion
15 Jan 2015
REC opinion
Further Information Favourable Opinion