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Upper Gastrointestinal Motor And Absorptive Function In Critically Ill Patients
Funder
National Health and Medical Research Council
Funding Amount
$260,760.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known abou ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating metabolic insults. Abnormal contractions of the oesophagus, stomach and small intestine appear to be common in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. However little is known about the reasons underlying these dysfunctions. The applicants, with ongoing support from the NH and MRC have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of these conditions. These contributions have been underpinned by pioneering the development of new methodologies to examine gut function. In collaboration with the intensive care specialists in Adelaide, we now seek to apply this knowledge to evaluate gut function in patients in the Intensive Care Unit. The proposed studies will provide the most comprehensive studies to date of the gut function in critically ill patients and have important implications for treatment.Read moreRead less
Oesophageal, Gastric And Small Intestinal Motility In Critical Illness
Funder
National Health and Medical Research Council
Funding Amount
$494,250.00
Summary
A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating insults. Abnormal contractions of the oesophagus, stomach and small intestine occur commonly in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. The applicants, with the support of the NH ....A major concern in critically ill patients is the provision of adequate nutrition to facilitate recovery from devastating insults. Abnormal contractions of the oesophagus, stomach and small intestine occur commonly in critically ill patients. These may prevent effective feeding of patients at a time when they are especially vulnerable to malnutrition and also result in major complications such as pneumonia, septicaemia and gastrointestinal haemorrhage. The applicants, with the support of the NH and MRC, have had a longstanding interest in motility disorders of the gut and have made important contributions to knowledge about both the causes and treatments of the disturbances that occur in the oesophaus, stomach and small intestine. In the previous grant (207753) these studies have provided the most comprehensive studies to date of the motor abnormalities associated with gut dysfunction in critical illness which have important implications for treatment. The applicants now seek to continue their work by investigating the mechanisms underlying these motor abnormalities and the impact of therapeutic strategies designed to enhance delivery of nutrition to critically ill patients.Read moreRead less
TRANSCUTANEOUS ELECTRICAL STIMULATION TO TREAT CONSTIPATION DUE TO ANORECTAL RETENTION IN CHILDREN
Funder
National Health and Medical Research Council
Funding Amount
$635,320.00
Summary
If you don't poop, you die! Over 20% of older people have constipation. It starts in childhood in 1/100 people and lasts through life. At the Royal Children’s Hospital, Melbourne, we have been developing a physiotherapy method using electrical stimulation across the skin to treat long-term constipation. In this study we are comparing this treatment to current treatment in the most common type of chronic constipation in children.
Development Of The GUTSTIM Device For The Treatment Of Intractable Constipation
Funder
National Health and Medical Research Council
Funding Amount
$380,746.00
Summary
We have developed a new treatment for chronic constipation that uses electrical stimulation through the skin similar to physiotherapy treatments for sports injuries. 20 million people (3% of children and 20% of the elderly) have chronic constipation. This proposal is to develop a simple purpose-built machine that has the best electronic properties for stimulating the intestine. The machine will be simple, easy to use and cheap, allowing safe use at home by children and the elderly.
Over 80 million people have chronic constipation. It affects over 1/5 older people and is a major problem in aged-care. We have found that a painless method of electrical stimulation across the abdomen can overcome chronic constipation in children and adults. We will test the method to see what types of constipation it can help, including constipation caused by pain-medication and irritable bowel syndrome. This treatment is given at home and could improve life for many people around the world.
Translational Studies Of Novel Methods For The Assessment Of Gastrointestinal Motility.
Funder
National Health and Medical Research Council
Funding Amount
$713,517.00
Summary
Swallowing has complex physiology and swallowing problems (dysphagia) result in poor nutrition and death due to complications of aspiration. A/Prof Omari has invented a new method to assess swallowing function. The studies proposed will change how dysphagia is diagnosed and managed. The research follows three streams: (A) studies in large patient cohorts in whom a better diagnosis is needed (e.g. stroke), (B) studies of therapies and interventions and (C) studies of swallowing biomechanics.
The Knotty Problem Of Enterochromaffin Cells And Gastro-intestinal Function: Unravelling Cause And Effect
Funder
National Health and Medical Research Council
Funding Amount
$403,097.00
Summary
It is crucial to understand how the food we eat controls the secretions and movements of a healthy or a diseased gastrointestinal (GI) system. One way control is achieved involves the release of serotonin (5-HT) from the enterochromaffin cells present in the epithelial lining of the intestine. This is the subject of our proposal and our results will help us to understand the causes of GI disorders and help to formulate new treatments.
Gut motility requires enteric neurons, which are located in the gut wall. During development, enteric neurons arise from precursors in the brain that migrate into the intestine. Failure of enteric neuron precursors to migrate and differentiate normally results in pediatric motility disorders. The aim of this research is to identify the mechanisms controlling the development of enteric neurons so that therapies can be developed for pediatric motility disorders.
Glucose is a critical fuel for living organisms and its presence in the gut triggers nerves that slow stomach emptying. However, little is known of how glucose is actually detected in the gut. We have established that sweet taste molecules of the tongue are also present in the gut, where they may detect glucose. This research will measure the expression and function of these molecules in the gut of humans and mice, and reveal key information on their potential as targets in health and disease.
Upper Gastrointestinal Motility And Glycaemic Control In Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$543,301.00
Summary
The application of novel techniques to evaluate gastrointestinal motor function has established that the rate at which the stomach empties is abnormally slow in ~50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying, which was thought to be an infrequent complication of diabetes, may contribute to a number of problems including symptoms such as nausea and bloating, and poor control of blood glucose concentrations. The blood glucose ....The application of novel techniques to evaluate gastrointestinal motor function has established that the rate at which the stomach empties is abnormally slow in ~50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying, which was thought to be an infrequent complication of diabetes, may contribute to a number of problems including symptoms such as nausea and bloating, and poor control of blood glucose concentrations. The blood glucose level itself also has a reversible effect on both stomach contractions and symptoms; when the blood glucose is abnormally high, the rate at which the stomach empties is slower, and symptoms, such as fullness, are greater. The rate of stomach emptying and the absorption of sugar from the intestine have a major influence on the rise in the blood glucose level after a meal. This is important because in people with diabetes it is desirable to maintain blood glucose levels as close as possible to normal to minimise the risk of complications such as eye and nerve damage. Specific modifications in diet and recently developed drugs which have actions similar to that of the hormone, glucagon-like peptide-1, may improve blood glucose control in type 2 diabetes by slowing the rate of gastric emptying. People with cystic fibrosis frequently develop diabetes which is often difficult to manage; this may result from abnormally rapid gastric emptying and impaired release of hormones. If so, pancreatic enzyme replacement, in the form of tablets, should prove effective. Our group has conducted research in this area for about 24 years and have performed the most comprehensive studies to date resulting in international recognition. The studies proposed in the current application represent a logical development from our previous work and have important implications for the management of diabetes.Read moreRead less