Reclassifying constipation using MRI and high resolution manometry
Research type
Research Study
Full title
Reclassifying constipation using magnetic resonance imaging combined with high resolution manometry: a validation study and double-blind crossover trial (RECLAIM study)
IRAS ID
209811
Contact name
Robin Spiller
Contact email
Duration of Study in the UK
3 years, 4 months, 30 days
Research summary
Constipation is a common condition in which an individual suffers with hard stools which are infrequent and difficult to pass. It is poorly understood and treatment is often unsatisfactory. Many patients also experience pain whilst others do not but it is unclear why . It is believed that the pain arises from contractions in the colon, the lower part of the intestines. Some patients with constipation have weak colonic contraction but surprisingly some, particularly those with a lot of pain have strong contractions which are poorly coordinated. These patients all suffer from constipation but would are likely to need very different treatments. At present we cannot identify what type of abnormality of colonic contractions each individual patient suffers from and so are unable to give them the best treatment. This study will take advantage of two new techniques which have been recently developed. Magnetic Resonance Imaging (MRI) which will allow us to see the contractions of the colon in response to a dose of the laxative Moviprep which increases the flow of fluid into the proximal part of the colon and High Resolution Manometry (HRM) which measures the power and direction of the contraction in much more detail than ever before using a pressure sensing catheter placed into the bowel. Using these 2 techniques we will identify the pattern of contractions in 80 patients with constipation and 40 healthy controls. We will then enter them into a controlled trial of either a drug which stimulates contractions or one which inhibits contraction. We anticipate that the pattern of contractions identified by the non-invasive MRI technique will predict which treatment will reduce their symptoms most as effectively as the more invasive HRM. If this is the case then our MRI test of colonic responsiveness could become widely used in routine clinical practice
REC name
East Midlands - Nottingham 1 Research Ethics Committee
REC reference
17/EM/0032
Date of REC Opinion
31 Jan 2017
REC opinion
Further Information Favourable Opinion