Gastroparesis

Researchers are evaluating how abdominal massage affects gastrointestinal functions in patients who are mechanically ventilated and receiving enteral nutrition in intensive care units. This study aims to assess abdominal massages impact on bowel movement frequency, gastric residual volume, and abdominal distension. The trial is designed as a prospective, single-blind randomized controlled trial to provide scientific evidence for abdominal massage use in this patient group. Participants are randomly assigned to either an intervention group receiving abdominal massage or a control group receiving standard care without massage. Abdominal massage is performed twice daily for 15 minutes over three days using specific techniques like effleurage, petrissage, and vibration. The massage is given at the bedside in a semi-Fowler position before enteral feeding, with routine nursing care provided to all patients. Throughout the study, researchers monitor bowel movements, gastric residual volume, abdominal distension, and stool consistency using specialized forms and scales twice daily. Data collection includes clinical assessments such as Glasgow Coma Scale and APACHE II scoring. The study lasts three days for each patient, with detailed recording of gastrointestinal function parameters to evaluate the effects of abdominal massage compared to standard care.

The GENESIS clinical study aims to map HLA genetic variation in the Greek population and evaluate possible correlations with selected underlying diseases. It is a multicenter, prospective, non-interventional clinical study targeting 12,000 subjects over an anticipated duration of 36 months, with the goal of creating a pilot HLA map for medical research and possible clinical applications. Each subject will complete one visit at a participating site and provide demographic information, including date of birth, gender, race, ancestry, height, and weight, as well as information about smoking or vaping, alcohol consumption, arterial blood pressure, diagnosed diseases, and current treatments. Recent clinical laboratory results from up to 12 months before sample collection may also be collected when available, including blood count, metabolic, liver enzyme, and biochemical parameters. Two buccal swabs will be collected from each subject for DNA extraction and HLA genotyping analysis. Selected DNA samples will also undergo low-pass whole genome sequencing to further investigate associations between the HLA region and autoimmune diseases. After the analysis is completed, an individualized ancestry report will be securely available to study subjects if they elect to access it.

Frailty is a common condition in older adults that can increase the risk of poor health outcomes such as falls, hospital stays, and death. This research aims to study how assessing frailty before a colonoscopy might affect patient satisfaction and the number of colonoscopies avoided. The study is a prospective randomized controlled trial involving patients over 65 years old at Princess Alexandra Hospital, comparing a personalized approach using a frailty assessment to standard care. Participants will be randomly assigned to one of two groups. One group will receive a personalized approach that includes a frailty assessment using tests like grip strength, sit-to-stand timing, balance, and gait speed, along with questionnaires about medical conditions. The gastroenterologist will discuss the results and risks with the patient to help decide about having a surveillance colonoscopy. The other group will receive standard care, which involves discussing the benefits and risks of colonoscopy without the frailty assessment. During the study, participants will complete satisfaction questionnaires at the time of consultation and within weeks after any colonoscopy procedure. Researchers will track how many patients choose to avoid colonoscopy after receiving information and will monitor colorectal cancer-related complications and other causes of death within five years. The study will assess how the personalized approach may impact decision-making and patient satisfaction with outpatient services related to colonoscopy care.

Researchers are evaluating the effectiveness and cost-efficiency of early remote interventions for patients with severe, chronic, or relapsing gastrointestinal symptoms that lack clear explanation and who are waiting for care in an integrated clinic. The study uses a two-stage randomization to compare different approaches, aiming to improve symptom management, identify which patients respond best to certain treatments, and assess acceptance of new care models. About 200 patients will initially have their symptoms and wheat intolerance assessed remotely. Participants who continue to experience symptoms after initial assessment will be randomly assigned to one of four pre-consultation interventions a standardized dietician-supervised program, an exercise program, internet-delivered cognitive behavior therapy, or no intervention. Following this, they will be randomized again to receive either a consultant-led outpatient clinic consultation or care in an integrated clinic, depending on their response to the pre-consultation intervention. Throughout the study, participants will be regularly assessed using a structured gastrointestinal symptoms score and quality of life measures, collected at multiple time points up to 44 weeks. Additional evaluations include anxiety and depression scales, microbiome analysis, and acceptance of care models by patients and staff. Cost-effectiveness will also be tracked. The total participation involves remote interventions, clinical consultations, and multiple assessments over time to monitor symptoms, quality of life, and treatment impact.

Researchers are evaluating the effectiveness of low volume Transanal Irrigation TAI using the Qufora IrriSedo MiniGo device combined with standard conservative treatments compared to conservative treatment alone for patients with Low Anterior Resection Syndrome LARS. This condition affects individuals who have undergone surgery for rectal cancer. The study aims to assess improvements in clinical symptoms of LARS over a three-month period. Participants are divided into two groups one receiving low volume TAI with the MiniGo device plus standard conservative care, which includes dietary management, counseling, and prescribed medications excluding suppositories and physiotherapy and another group receiving only the standard conservative treatments. The study includes follow-ups at 6 weeks, 3 months, and up to 12 months to monitor various outcomes. During the study, participants will be regularly assessed using the LARS score to measure symptom changes, quality of life questionnaires EORTC QLQ-C30 and QLQ-CR29, incontinence scores, patient satisfaction, treatment compliance, bowel management time, and healthcare resource usage. Data will be collected at multiple intervals including 6 weeks, 3 months, 6 months, 9 months, and 12 months to thoroughly evaluate the treatment impact and patient preferences.

Cyclic vomiting syndrome CVS is a disorder mainly seen in children, characterized by repeated episodes of severe vomiting and abdominal pain often linked with migraine symptoms. This condition causes significant disability and greatly impacts quality of life, with many children requiring emergency care. Current treatments mainly involve antidepressants, which can have serious side effects and are often ineffective, highlighting the need for safer, non-drug therapies. The study aims to evaluate the effects of non-invasive auricular neurostimulation, specifically percutaneous electrical nerve field stimulation PENFS, on reducing CVS episode frequency, duration, and severity in children aged 5 to 18 years. Participants will be randomly assigned in a 21 ratio to receive either active or sham PENFS therapy. The active treatment involves auricular vagus nerve stimulation using a device worn on the outer ear for 5 consecutive days per week over 5 weeks. The sham group will use a similar device without active stimulation for the same duration. This randomized, sham-controlled design allows comparison of the effects of PENFS on CVS symptoms while maintaining blinding. During the study, children will be monitored for changes in the burden of CVS episodes from baseline to 6 months after treatment ends. Researchers will assess outcomes including episode frequency, duration, severity, and quality of life using validated scales. Follow-up will continue for 12 months after therapy completion, with regular evaluations of symptoms and functional disability. Safety will be monitored throughout, with adherence to treatment and symptom tracking recorded to understand PENFSs impact on this condition.

This trial is focused on adults with cancer who are receiving chemotherapy and experience nausea and vomiting as side effects. Researchers are studying a drug called LY3537021 to see how well it controls these symptoms and to evaluate its safety. The study is a Phase 2, double-blind, placebo-controlled trial designed to better understand the treatment options for chemotherapy-induced nausea and vomiting in this population. Participants are randomly assigned to receive either LY3537021 or a placebo, both given as a subcutaneous injection before chemotherapy. All participants also receive standard anti-nausea treatments, which may be taken orally, intravenously, or through skin patches. The chemotherapy drugs involved include cisplatin or an anthracycline and cyclophosphamide combination. The study treatment is given prior to chemotherapy, and the trial lasts about two months per participant. During the study, participants will be monitored for nausea and vomiting from the time of their chemotherapy infusion through up to five days afterward. Researchers will collect data on symptom control, the need for rescue medications, and drug levels in the body. Participants will complete diaries to track nausea severity. Safety and response to treatment are carefully observed. The study aims to measure how many participants have a complete response to nausea and vomiting during the delayed phase after chemotherapy.

Researchers are studying nutritional support strategies for critically ill patients with impaired gastrointestinal function, focusing on how to best achieve energy and protein intake goals. The study investigates the use of enteral nutrition alone versus a combination of enteral nutrition and supplemental parenteral nutrition SPN in patients who have impaired gastric emptying and reduced intestinal absorption. This research addresses the challenge of feeding intolerance and malnutrition in intensive care patients and explores muscle mass and function as important factors in nutrition efficacy. The study randomly assigns patients with diagnosed gastrointestinal dysfunction to one of two groups one receiving gradual increases in enteral nutrition based on tolerance, and the other receiving a mix of enteral trophic feeding plus SPN to meet nutritional targets. Nutritional needs are monitored daily by indirect calorimetry, and gastrointestinal function is assessed with ultrasound gastric residual volume and a paracetamol absorption test. The SPN group aims to reach 80% of nutritional goals by day five, while the enteral nutrition group aims for full caloric intake as tolerated. Participants are monitored through various evaluations including muscle thickness via ultrasound, lean body mass by bioelectrical impedance analysis, and muscle strength with a handgrip dynamometer at admission and on days 10 and 15. The study measures daily calorie and protein intake adequacy, metabolic markers, and clinical outcomes such as mortality up to 28 days. Nutritional status, muscle function, and energy utilization are carefully assessed throughout the study to understand the impact of the tailored feeding protocols.

Researchers are evaluating acupuncture as a treatment for delayed gastric emptying that occurs after partial gastrectomy surgery. This multicenter, randomized, controlled trial aims to provide strong evidence on the effectiveness and safety of acupuncture in improving gastric motility and reducing symptoms like abdominal distension, nausea, and vomiting in patients with postoperative gastroparesis. The study is conducted collaboratively by Qilu Hospital of Shandong University and partner institutions. Participants are randomly assigned to one of two groups an Acupuncture Group receiving traditional Chinese medicine acupuncture plus standard postoperative care, and a Sham Acupuncture Group receiving non-penetrating sham acupuncture plus the same standard care. Both groups receive treatments of equal duration and frequency. The study collects clinical data, laboratory samples, and symptom assessments during treatment, with follow-up over 12 months. Throughout the trial, participants undergo assessments including gastric emptying scintigraphy, abdominal radiographs, symptom scoring with the Gastroparesis Cardinal Symptom Index, nutritional status evaluations, quality of life questionnaires, and monitoring of adverse events. Safety and treatment credibility are also evaluated. Follow-up visits occur at 1, 3, 6, and 12 months post-treatment to monitor recovery and long-term outcomes. The primary outcome is the time to recovery from gastroparesis up to 12 months after diagnosis.

This research aims to understand the training experience of senior general surgery residents in advanced gastrointestinal GI surgical procedures during residency. It focuses on identifying who provides this training and assessing residents self-reported comfort and competence in performing both common and complex GI surgeries. The study highlights the importance of evaluating the need and interest in an Advanced GI Surgical fellowship among senior residents as they consider further specialized training or beginning independent practice. Participants include fourth and fifth year general surgery residents in accredited residency programs across the United States. The study collects data through an anonymous survey about their training in advanced GI procedures and their comfort level with managing GI surgical pathologies. This observational study does not involve any medical interventions or treatments. Throughout the study, participants complete surveys that assess their training experiences and confidence in GI surgical skills. Researchers analyze these responses to better understand educational gaps and fellowship needs. The primary outcome is focused on the training of senior general surgical residents over one year. Participation involves completing the survey without any active treatment or procedures, and the study is conducted anonymously to ensure privacy.