small intestinal function tests in gut motility disorders
Research type
Research Study
Full title
The clinical use of small intestinal function tests in gastrointestinal motility disorders
IRAS ID
258248
Contact name
Nikhil Thapar
Contact email
Sponsor organisation
UCL Institute of Child Health
Duration of Study in the UK
4 years, 11 months, 30 days
Research summary
Gut motility disorders include many different diseases that affect function of the intestine. The most severe form, paediatric intestinal pseudo-obstruction involves the small intestine limiting its ability to propel food, not because of physical blockage of the intestine (mechanical obstruction) but functional failure of its neuro-musculature. There is little understanding of the precise abnormalities present and delays in making a definitive diagnosis, which both increase the risks of ineffective treatments being applied. Imaging lacks the ability to differentiate between functional and mechanical obstruction and better diagnostic tools needed, including taking intestinal samples at surgery (histopathology) or measuring intestinal contractions (antroduodenal manometry; ADM). However, these tests give limited information on the precise nature of intestinal neuromuscular abnormalities. Thus, other tests have been considered including a special camera to track the movement of an ingested radioactive isotope through the intestine (scintigraphy) and physiology tests on intestinal tissue samples.
We aim to evaluate the clinical utility of investigative tools (contemporary and enhanced protocols), including ADM, histopathology, scintigraphy and tissue physiology, to provide a more accurate diagnosis and understanding of neuromuscular abnormalities present in gut motility disorders.
To do this, as well as get control data from non-motility disorder patients, all children referred to Great Ormond Street Hospital for in-depth evaluation of gastrointestinal disorders as part of their routine clinical care will be included. Participants will undergo investigations according to standard clinical care with the project seeking to either enhance analysis of investigative tools (ADM, Histopathology) or adapt protocols to better understand pathophysiology (scintigraphy, tissue physiology). Most patients may go onto to have surgery as part of standard care during which full thickness tissue samples are taken. The project will use residual tissue from these samples for histopathology and tissue physiology tests. Intestinal scintigraphy will involve slightly longer screening times but no additional radiation exposure.REC name
London - Brent Research Ethics Committee
REC reference
19/LO/0854
Date of REC Opinion
29 Jul 2019
REC opinion
Further Information Favourable Opinion