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Neural Crest Stem Cell Therapy For Absence Of Intestinal Nerves In Hirschsprungs Disease
Funder
National Health and Medical Research Council
Funding Amount
$504,377.00
Summary
Hirschsprung's disease is acommon birth defect caused by failure of nerve cells to get into the colon. This results in intractable often fatal constipation. Current treatment is surgical removal of the affected colon soon after birth but often problems persist. These nerves might be rebuilt using nerve stem cells, but not all stem cells have this capacity. And is not known if this can be achieved after birth: This project will define which stem cell populations to use and in what age of bowel.
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$82,450.00
Summary
1 in 300 children suffer from chronic constipation that is not fixed by changing their diet or taking laxatives. They continue to suffer the problem into adulthood. They also have fecal incontinence or soiling that causes problems with socialising and schooling. We are testing a method of electrical stimulation through the skin on the belly to increase the movement of the bowel. Initial results are encouraging, showing that the rate of movement of the bowel is increased and soiling is decreased.
Transcutaneous Electrical Stimulation To Relieve Chronic Constipation In Children
Funder
National Health and Medical Research Council
Funding Amount
$346,995.00
Summary
We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the ....We have over 300 children with chronic treatment-resistant constipation at Royal Children's Hospital Melbourne. We have a new physiotherapy technique that may overcome constipation and stop soiling in many of these children. In 2003-4, we ran a pilot study to test a technique used by physiotherapists to treat urinary incontinence. We have called the method TESIC (transcutaneous electrical stimulation using interferential current). TESIC uses suction electrodes placed on the belly and back at the level of the belly button. The electrical stimulation is applied using a current (interferential current) that stimulates deep into the abdomen. We tested 8 children and had very encouraging results with improved constipatio in 5-8 and all with soiling stopped. Parents and children are keen to use this technique but first we need to establish that the results are reproducible in a larger group of 70 children. We also need to know if the effect was just a placebo response (due to time spent with the physiotherapists), and how long the effect lasts. We will also measure changes in soiling. Faecal soiling is smelly and antisocial. Relief of soiling has a big impact on a child's ability to fit in at school and to attend normal schooling. We will measure outcomes using daily diaries kept by children, questionnaires, how quickly food moves through the bowel and pressures within the bowel. We have a multidiciplinary team of experienced clinicians and scientists with expertise in these techniques and in constipation and incontinence in children (paediatric surgeon, gastroenterologist, manometry nurse, incontinence paediatrician and physiotherapist, expert in electrical stimulation and gut nervous system scientist). This technique could revolutionise treatment of chronic constipation. Most physiotherapists have TESIC machines, allowing delivery Australia wide. It is non-invasive and should also be able to be used by adults, including the elderly in nursing homes.Read moreRead less
Neuro-muscular Apparatus In Human Colon And In Children With Chronic Constipation
Funder
National Health and Medical Research Council
Funding Amount
$195,660.00
Summary
NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, ....NIDKIDS is a support group for children with chronic constipation. There are 200 patients at the Royal Childrens Hospital in Melbourne who are in this group because their constipation has not responded to any treatments. Movement of food along the intestine requires muscle in the wall of the intestine to contract in a coordinated pattern. Coordination of the muscle contractions is provided by the nervous system. The nervous system controlling the gut has cell bodies located within the gut wall, that send processes to the muscle and lining of the gut. There are sensory neurons, motor neurons and neurons that connect between the other neurons (interneurons). Nerves communicate between each other and cause muscles to contract by releasing chemicals (transmitters). In the last decade, we have discovered that communication between the nerve and muscle cells occurs through a third cell type- interstitial cells of Cajal. These cells also have a role as pacemaker cells for the muscle cells. In a small study, we have found that the muscle can contract in response to transmitters but that activation of the nerves does not result in muscle contraction in NIDKIDs. This result shows that transmission from neurons to muscle is not occuring in large bowel from NIDKIDs. In this study, we will examine a larger group of patients to determine if a functional defect in the muscle, a defect in the nerve chemical transmitters or a lack of the intermediate cells (the interstitial cells of Cajal) is causing the problem in the NIDKIDs. Further treatment of each patient will be easier if the defect causing his-her problem is known. We would then be able to target their problem with drugs that would work specifically at the point of breakdown in their individual gut.Read moreRead less
ATP Release From Gastrointestinal Epithelium: A Potential Target For The Treatment Of Slow Transient Constipation
Funder
National Health and Medical Research Council
Funding Amount
$317,775.00
Summary
Slow transit constipation (STC) is a severe condition of the colon, almost exclusively affecting reproductive age women with no effective treatment. We recently found an association between STC and defects in connexin proteins in the large intestine. We aim to reveal the role of connexins and female hormones in the maintenance of normal intestinal function and their involvement in STC. The study will provide completely new perspectives in the understanding of the functional bowel disorders.
Childhood Precursors Of Adult Cardiovascular Disease, Obesity And Diabetes- 16 Year Follow Up Of A Longitudinal Cohort
Funder
National Health and Medical Research Council
Funding Amount
$835,631.00
Summary
There is a world wide 'epidemic' of obesity and diabetes with rates tripling in young adults in the last twenty years. This is likely to lead to an upsurge in heart attack and stroke and to reverse many of the gains seen in this area in Australia. This project aims to study the childhood and antenatal precursors for the risk of adult obesity, diabetes, heart disease and stroke. The study involves The Perth longitudinal childrens 'Raine' cohort, a unique group of just under 3000 children, first m ....There is a world wide 'epidemic' of obesity and diabetes with rates tripling in young adults in the last twenty years. This is likely to lead to an upsurge in heart attack and stroke and to reverse many of the gains seen in this area in Australia. This project aims to study the childhood and antenatal precursors for the risk of adult obesity, diabetes, heart disease and stroke. The study involves The Perth longitudinal childrens 'Raine' cohort, a unique group of just under 3000 children, first monitored in the womb before mid pregnancy and then repeatedly through to the age of 13 years. Every 2 to 3 years the study children have been carefully assessed for changes in fatness, blood pressure and more recently, nutrition, physical activity and fitness, blood cholesterol and tendency to diabetes. Families have also been carefully monitored for a range of social characteristics and mental health. We already have evidence that about a fifth of the children at age 8 are particularly at risk of obesity, diabetes and cholesterol problems and high blood pressure. We now plan to study the children after puberty at age 16, when they will be adopting a range of more adult behaviours which may profoundly affect these risks. This study will provide comprehensive information on the children from before birth to adolescence and help pinpoint ways in which growth in the womb, and subsequent childhood behaviour interacts with influences of family, social factors, environment and mental health to affect long term risk of obesity, premature diabetes or heart disease. The study will also provide a basis for future examination of the links between genes, environment and health.Read moreRead less
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.
Mechanical Factors In Normal Human Colonic Motility
Funder
National Health and Medical Research Council
Funding Amount
$650,023.00
Summary
Abnormal human colonic contractions cause significant medical, societal and financial burdens. Diagnosis and treatment of motility disorders requires an understanding of normal colonic contractility against which to measure dysfunction. Through state-of-the-art recording and analytical techniques, developed by the applicants, this project will provide the first clear description of normal human colonic motor patterns and how they are generated.