Reclassifying Constipation Using Imaging and Manometry
Status:
Unknown status
Trial end date:
2021-06-01
Target enrollment:
Participant gender:
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. Participants will
then enter 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
Phase:
N/A
Details
Lead Sponsor:
University of Nottingham
Collaborators:
Queen Mary University of London University College, London