Structure and Function of the Gastro-esophageal Junction
Combined Magnetic Resonance Imaging and High Resolution Manometry Studies
Aims of research project:
To identify key features of the gastro-esophageal junction (structure and function) that protects the esophagus from gastro-esophageal reflux investigated by combined high resolution manometry and magnetic resonance imaging.
Hypothesis:
- Functional factors including GEJ function (e.g. sphincter pressure) and proximal gastric distension determine whether or not TLESR occurs; however
- Structural factors including separation of GEJ anatomy, intra-gastric distribution of the meal and secretions determine whether TLESR is accompanied by no reflux event, gas reflux (belching) or reflux of ingested food and gastric secretion ('true reflux').
- Initial findings by descriptive studies in healthy volunteers (study #1) and patients with mild to moderate gastro-esophageal reflux disease (study #2) will be further interrogated by a randomized, double-blind control trial of baclofen in patients with GORD; a medication that inhibits reflux by effects on GOJ function (study #3) .
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Faktiske)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
-
Zurich, Schweiz, CH-8091
- Division of Gastroenterology
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion criteria:
Study #1:
- healthy male and female volunteers
- aged at least 18 and not more than 49 y
- no history of gastrointestinal symptoms
- able to communicate well with the investigators and to comply with the requirements for the entire study
- who provided written informed consent before participating in the study, after being given a full description of the trail.
Study #2 and #3:
- male and female patients with mild to moderate gastro-oesophageal reflux disease defined by presence of (1) reflux symptoms (2) pathological esophageal acid exposure between 5-10% on 24 hour ambulatory testing
- aged at least 18 and not more than 49 y
- no history of gastrointestinal symptoms
- able to communicate well with the investigators and to comply with the requirements for the entire study
- who provided written informed consent before participating in the study, after being given a full description of the trail.
Exclusion criteria:
- with present psychiatric disorders or mental impairment limiting the ability to comply with study requirements
- with use of medications influencing upper GI motility within one week of the study (i.e. beta- blocker, calcium channel blockers, nitrates, prokinetic drugs, macrolide antibiotics)
- with regular intake of medication; occasional use of analgesic e.g. aspirin, paracetamol is allowed
- with symptoms or a history of gastrointestinal disease other than gastro-esophageal reflux disease (in study #2 and #3)
- suffering from known liver, kidney, cardiovascular, neurological or pulmonary disease
- with any evidence of infectious disease
- with evidence or history of drug or alcohol abuse
- with insufficient knowledge of the German language • who, for any reason, are unable to complete the study
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Diagnostisk
- Tildeling: Randomiseret
- Interventionel model: Crossover opgave
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Aktiv komparator: Baclofen
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
|
Baclofen suspension 40mg (single dose 90 minutes prior to physiologic measurement)
|
|
Placebo komparator: Placebo
Placebo suspension (single dose 90 minutes prior to physiologic measurement)
|
Placebo single 'dose' 90 minutes prior to study
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Gastro-oesophageal insertion angle, contact span (of stomach on oesophagus)
Tidsramme: Pre- and post-meal ingestion
|
Gastro-oesophageal morphology from MRI imaging: insertion angle, contact span (of stomach on oesophagus) assessed from 3D models of stomach reconstructed from MRI imaging
|
Pre- and post-meal ingestion
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
gastric emptying
Tidsramme: post-meal
|
dynamic change in gastric and meal volumes over course of study assessed from MRI imaging.
gastric emptying assessed from complete data set
|
post-meal
|
|
gastric accommodation
Tidsramme: post-meal
|
dynamic change in gastric and meal volumes over course of study assessed from MRI imaging.
gastric accommodation assessed from complete data set
|
post-meal
|
|
number of reflux events
Tidsramme: post-meal
|
assessed by presence of common cavity events on (high resolution) manometry
|
post-meal
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Publikationer og nyttige links
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Faktiske)
Primær færdiggørelse
Studieafslutning (Faktiske)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Sygdomme i fordøjelsessystemet
- Gastrointestinale sygdomme
- Esophageal Motilitetsforstyrrelser
- Deglutition lidelser
- Esophageale sygdomme
- Gastroøsofageal refluks
- Lægemidlers fysiologiske virkninger
- Neurotransmittermidler
- Molekylære mekanismer for farmakologisk virkning
- Agenter fra det perifere nervesystem
- GABA agenter
- Neuromuskulære midler
- Muskelafslappende midler, Central
- GABA-agonister
- GABA-B-receptoragonister
- Baclofen
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- EK 1361
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