Gastric Motility And Blood Glucose Control In Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$354,947.00
Summary
The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate of which the stomach empties food is slow in up to 50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. It is now recognised that disordered stomach emptying may contribute to a number of problems i ....The recent application of novel techniques to evaluate gastrointestinal motor function has established that the rate of which the stomach empties food is slow in up to 50% of people who have insulin-dependent (type 1) or non-insulin dependent (type 2) diabetes. Delayed stomach emptying was thought to be an infrequent complication in diabetes; much less common than damage to the eyes, kidneys or nerves. It is now recognised that disordered stomach emptying may contribute to a number of problems in diabetes, e.g. symptoms such as nausea and bloating and poor control of blood glucose concentrations. In some people symptoms are disabling and affect quality of life adversely. The effects of stomach emptying on blood glucose control is likely to be important, as it is desirable to maintain blood glucose levels within the normal range to minimise the risk of both the development and progression of complications of diabetes. In many people with diabetes, particularly older people with type 2 diabetes, there is a fall in blood pressure after a meal which may result in fainting and falls. The magnitude of the fall in blood pressure is determined by the rate at which the stomach empties; faster emptying results in a greater fall in blood pressure. In the past both slow stomach emptying and symptoms were assumed to result from irreversible nerve damage, however it is now recognised that the blood glucose level itself has a reversible effect on both stomach contractions and symptoms. Our group has been the recipient of ongoing support from the NH and MRC for approximately 15 years to conduct research in this area. As a result we have performed the most comprehensive studies to date and developed new methods to evaluate stomach function in people with diabetes, resulting in international recognition. The studies proposed in this current application represent a logical development from our previous work and have important implications for the management of diabetes.Read moreRead less
Development Of Diagnostic Tools To Characterise Predictors Of Therapeutic Outcome In Severe Constipation
Funder
National Health and Medical Research Council
Funding Amount
$433,999.00
Summary
This project will use fibre-optic technology to create detailed high resolution maps of colonic motor patterns in both health and in patients with severe constipation. The data will be used in combination with actual patient symptoms to help identify specific markers of disease that can differentiate sub-types of constipation and ultimately guide and improve treatment in constipated patients
Defining The Colonic Abnormality Underlying Severe Constipation And Evaluating The Efficacy Of A Novel Treatment Therapy
Funder
National Health and Medical Research Council
Funding Amount
$487,990.00
Summary
This project aims to clarify the contractile patterns of the human colon which underlie the very common and distressing condition of constipation. We will be relating symptoms of constipation from a large number of sufferers with actual measurements of contractions along the colon in these patients. Furthermore by examining the in vivo colonic motor response to electrical stimulation of pelvic floor nerves, we will help to determine the potential of this new form of treatment for constipation. T ....This project aims to clarify the contractile patterns of the human colon which underlie the very common and distressing condition of constipation. We will be relating symptoms of constipation from a large number of sufferers with actual measurements of contractions along the colon in these patients. Furthermore by examining the in vivo colonic motor response to electrical stimulation of pelvic floor nerves, we will help to determine the potential of this new form of treatment for constipation. The aims of these projects will be to try and identify abnormal motor patterns responsible for constipation as well as determining a possible inductor of normal colonic motility so that future studies can target appropriate treatment at the responsible defect.Read moreRead less
Predicting Dysphagia-related Complications And Improving Outcomes In Patients Treated With Head And Neck Radiotherapy
Funder
National Health and Medical Research Council
Funding Amount
$311,597.00
Summary
This project aims to improve swallow-related quality of life in patients undergoing head and neck radiotherapy by: 1) Identifying throat muscles, critical to swallowing in order to refine future radiation strategies in order to minimise collateral damage to these critical structures; 2) Improve health care management of post-radiotherapy patients via identification of markers that predict response to therapy; 3) Evaluate a therapy to improve swallow dysfunction
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
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.
An Objective Screening Test For Deglutitive Aspiration And Swallowing Function In Children With Dysphagia
Funder
National Health and Medical Research Council
Funding Amount
$476,641.00
Summary
Swallowing dysfunction (dysphagia) is common in children with neurological diseases such as cerebral palsy which affects 1:400 births. Fluid in the lungs during swallow (aspiration) is a serious complication causing chest infections and potentially death. We have developed a new test measuring pressures and flows during swallow which can detect abnormalities predisposing to aspiration and we will evaluate this as a screening tool.