Investigation of the effect of L. casei Shirota on preventing abdominal symptoms and small intestinal bacterial overgrowth in patients with gastro-oesophageal reflux disease(GORD) newly treated with proton pump inhibitors(PPI): A randomised controlled pilot trial.
A Multi-Centre, Randomized, Placebo-Controlled, Efficacy Study of Prebiotic Galacto-oligosaccharides on Gastrointestinal Symptom Severity in Patients with Irritable Bowel Syndrome.
Lead: Qasim AzizProfessor of NeurogastroenterologyDirector of the Wingate Institute
Neurogastroenterology is a discipline of gastroenterology, aimed at understanding the neuromuscular control of gastrointestinal function, with particular emphasis on brain-gut interactions. The Neurogastroenterology Group is a multidisciplinary collaboration of experts, both clinicians and scientists, including adult and paediatric neurogastroenterologists, GI pathologists, physiologists, psychologists and psychiatrists, surgeons, immunologists, neuroscientists, and physicists. They are working across the Blizard Institute, Barts and The London School of Medicine and Dentistry, and Barts Health NHS Trust to advance basic scientific study and translate this knowledge to enhance patient care.
There are four major areas of our research on the gastrointestinal system: pain, neurodegeneration and ageing, reflux, obesity and connective tissue, all addressed by the neurogastroenterology group. The activities of the group span the disciplines of Gastroenterology, Gastrointestinal surgery, Psychiatry, Pharmacology, Neuroscience, Neurology, Immunology, Nutrition and Endocrinology. Many of our members are specialists in one or more of these areas and/or disciplines. The approaches comprise Molecular and Cellular, Experimental and Translational, and Population-based medicine, providing a vertical and horizontal matrix between our research themes. Our many collaborations clearly demonstrate the high level of national and international outreach. Our publication record emphasises our multidisciplinary approach. We provide state-of-the-art research facilities that promote sharing of resources within the campus. We have both individual and collective projects addressing four levels of investigation in each programme.
The four levels are:
Principal investigators: Qasim Aziz, Madusha Peiris, Daniel Sifrim, Charles Knowles, Dr Rubina Aktar
Principal investigators: Gareth Sanger
Principal Investigators: Daniel Sifrim, Philip Woodland
Principal Investigators: Dr Madusha Peiris and Dr Rubina Aktar
Enteric Nervous System:
Fundamental research on function of human and mouse sensorimotor cells and systems:• Peripheral mechanisms of mechanical and chemical induced gut pain pathways.• Identification of novel molecular targets for motility, sensory and inflammatory gut disorders.Understanding molecular mechanisms of human gut diseases:• Oesophageal sensitization• Inflammatory Bowel Disease• Irritable Bowel Syndrome
Obesity and Appetite Regulation:
Fundamental research on function of human sensorimotor cells and systems• Nutrient receptor mechanisms in the gut epithelium• Enteroendocrine communication between the gut and the CNSUnderstanding disease in humans• Changes in enteroendocrine cell function in obesity• Stress and neuroendocrine responses
New diagnostics, therapies and personalized medicine• Mechanism of action of bariatric surgery• Cell-based – vagal afferent neurons and enteroendocrine cells• Organ-based – enteroendocrine-vagal-brain communication• Clinical trials of anti-obesity treatments in obese patients
Role of Microbiota in regulating enteric nervous system:
Characterising the effect of microbial populations on:• Neuronal subtypes innervating the gut• Function and activity of ENS mediated processes e.g. motility, secretion and sensory signalling.• Enteroendocrine cell populations and downstream activity/interaction with ENS
Principal Investigator: Qasim Aziz
Dr Nick Croft’s teaching role lies in organising the highly regarded MSc in Gastroenterology, which supports research both via projects run within the course and by attracting quality students to study for higher degrees. Recently, the Centre for Digestive Diseases has secured funding from the UEGF to develop a pan-European e-learning MSc programme in Gastroenterology, with neurogastroenterology being one of the main modules in this programme.
The GI Physiology Unit is an accredited national training facility. Dr Scott, Professor Sifrim and Dr Yazaki supervise the training of both internal and external practitioners (physiologists, nurses, physicians and surgeons) in GI physiological investigative techniques.
The senior faculty of the neurogastroenterology group supervise a number of graduate and postgraduate students. In addition to the 20 research fellows listed on this website, we have supervised numerous PhD students, MPhil students, MD students, and post-doctoral fellows in the past five years. Note: Prospective students should contact Professor Qasim Aziz at firstname.lastname@example.org to discuss possibilities for future research.
The Neurogastroenterology group is delivering an education programme through organisation of regular national and international meetings, seminars and workshops. Members of the group already have a leadership role in Education in Europe. Professor Aziz is a member of the executive committee and the lead for education for the European Society of Neurogastroenterology and Motility. He is also a member of the Executive Committees of the neurogastroenterology section of the British Society of Gastroenterology (BSG), and serves on the Education and Scientific Committee’s of United European Gastroenterology Federation (UEGF). Other members of the group such as Mr Knowles, Dr Scott and Professors Sifrim, MacDonald and Giovannoni also have leadership roles in education within UK and Europe.
Our educational programme has received support and sponsorship from the BSG, UEGF, and European Society of Neurogastroenterology and Motility, which has facilitated international meetings, workshops and seminars on a range of topics. Furthermore, The Centre for Digestive Diseases has recently secured funding from the UEGF to develop a pan-European e-learning MSc programme in gastroenterology, with GI neuroscience being one of the main modules in this programme.
Wingate public engagement activity [DOC 16KB]
Barts Health NHS Trust has one of the premier gastroenterology departments in the country, with a wide referral base covering all aspects of the speciality.
Neurogastroenterology has traditionally been an area of strength within the gastroenterology department, and is unique in providing adult and paediatric medical and surgical clinics supported by the nationally eminent GI physiology diagnostic unit. The group has a long tradition (more than three decades) for receiving both national and international referrals for the diagnosis and treatment of patients with disorders of GI function.
Multidisciplinary joint clinics are now in place for complex patients, involving paediatricians, psychologist, psychiatrists and pain management specialists. Overall, all the combined clinics receive approximately 1,000 referrals per year providing a rich resource for clinical research. The new hospital being built at the Whitechapel site is state-of the art teaching hospital with the largest private finance initiative in the UK. Gastroenterology will be one of the largest clinical groups within this hospital.
Information for patients attending the GI Physiology Unit
Patient information guide on Oesophageal ManometryPatient information guide on 24-hour Oesophageal pH monitoringPatient information guide on colonic and anorectal physiology testsPatient information guide on anorectal physiology tests
A specialist gastroenterology clinical research centre, The Wingate Clinical Trials Facility (WCTF) has emerged at the Wingate Institute of Neurogastroenterology, which is an internationally recognised centre of excellence. The WCTF has bespoke facilities and its staff have specialist expertise for performing gastroenterology-related clinical research. We run Phase II-IV commercial and non-commercial trials. In addition, we conduct clinical trials in gastroenterology which require highly specialised procedures and investigations, for which appropriately trained staff and equipment are provided. The team have excellent experience and the infrastructure is in place for undertaking such trials.
We strive to develop good relationships with our clients and in particular our patients through effective communication and transparency in all our activities. We have resources to design, conduct and disseminate clinical trials in a broad range of gastrointestinal diseases. Our principal investigators are leaders in their respective fields and are available to contribute to all aspects of clinical trials.
Wingate Brochure [PDF 3,138KB]
The Wingate Clinical Trials Facility provides clinical space, laboratory facilities, pharmacy and specialist staff dedicated to clinical research.
The facilities we offer are a comprehensive, accessible and efficient service, supporting researchers in all aspects of study conduct including:
Our values are central to how we operate, and we strive to achieve the highest possible standards by:
Barts Health NHS Trust
Blizard Institute, Centre for Neuroscience, Surgery and Trauma, QMUL
National Bowel Reseach Centre (NBRC)
Our current research programmes are wide-ranging and currently include:
1. YAKULT Study (Investigator Lead Study): Investigation of the effect of L. casei Shirota on preventing abdominal symptoms and small intestinal bacterial overgrowth in patients with gastro-oesophageal reflux disease(GORD) newly treated with proton pump inhibitors(PPI): A randomised controlled pilot trial.
Sponsor: Queen Mary University of London
Principal Investigator: Dr Etsuro Yazaki
The recruitment target is 44 patients with GORD who are newly on PPI. 2 groups: Group 1: 22; with Yakult, Group 2: 22; without Yakult. Main Inclusion Criteria:
2. EGIS study (Commercial Study): A Multi-Centre, Randomized, Placebo-Controlled, Efficacy Study of Prebiotic Galacto-oligosaccharides on Gastrointestinal Symptom Severity in Patients with Irritable Bowel Syndrome
Sponsor: Clasado Research Services Ltd
Principal Investigator: Prof. Qasim Aziz
The recruitment target 50 patients. Main inclusion Criteria:
Wingate Clinical Trials Facility (WCTF)Blizard InstituteQueen Mary University of London26 Ashfield StreetLondon, E1 2AJ
Telephone: 020 7882 2645
Neurogastroenterology GroupCentre for Neuroscience, Surgery and TraumaBlizard Institute26 Ashfield StreetWhitechapelLondonE1 2AJ