Principal Investigator: Ronak Vashi Patel, MD Imagine a piece of food becomes stuck in your throat while eating dinner. Unfortunately, for many patients with Eosinophilic Esophagitis (EoE), this is a symptom that occurs all too often. Dysphagia, or difficulty swallowing, is a gastroenterology “red flag” that often alerts physicians to initiate a work up to determine the cause. Typically, the first step calls for an upper endoscopy to visually assess inflammation and narrowing (strictures) that can be treated. Prior data suggests that visual evaluation is not perfect. Missed strictures can lead to additional testing and delay diagnosis. Other tools have become available to assist in measuring the esophageal diameter such as the Functional Lumen Imaging Probe (FLIP), a novel technology. Dr. Patel’s research project aims to determine how accurately physicians measure esophageal diameter as compared to FLIP in patients with EoE. Better understanding the accuracy of endoscopic assessment by both visual estimation and FLIP assessment will offer insight into which tools should be used in diagnostic and therapeutic treatment of esophageal...
Principal Investigator: Eric S. Hungness, MD Muscular weakness at the junction of the diaphragm and esophagus (hiatal hernia) is a common problem that may result in heartburn, difficulty swallowing, or anemia. Current surgical repair techniques have an unacceptably high hernia recurrence rate. A novel surgical material was developed at Northwestern University and has demonstrated promising results in animal and human studies. This project will investigate the efficacy of an innovative mesh suture in hiatal hernia repair, as compared to the current gold standard material. The principle outcome of interest will be measured by a non-invasive x-ray examination 6 months following surgery. The hope is that patients undergoing repair with the novel material will have...
Principal Investigator: Nikhilesh Mazumder, MD, MPH Severe damage to the liver can profoundly affect a variety of body systems. Patients with cirrhosis suffer from excess fluid in the legs, abdomen, and chest. Medications can reduce fluid buildup but dosing is not an exact science. Inaccurate dosing can harm the kidneys, cause confusion, and even land patients in the hospital. To avoid these complications, clinicians rely on a multitude of blood and imaging tests that often require expensive equipment, drawing blood, or specially trained staff. Dr. Mazumder’s team seeks to simplify the process by testing the benefit of a decades-old technique called the Valsalva maneuver in combination with a finger photoplethysmography device (similar to a noninvasive bedside pulse oximeter). Patients hold their breath for 10 seconds, and the device measures changes in blood flow to the finger. Safely and successfully tested in individuals with heart problems to predict levels of fluid overload, the...
Principal Investigator: Richard M. Green, MD A chronic bile duct and liver disease, Primary Sclerosing Cholangitis (PSC) affects more than 50,000 Americans and can progress to cirrhosis, liver failure, and bile duct cancer. Currently, the only effective therapy is liver transplantation. Better understanding the pathogenesis of PSC is urgently needed to develop new therapies. In recent cell culture and animal studies, Dr. Green and his colleagues focused on a protective cell signaling pathway: the unfolded protein response (UPR). They found that the UPR is activated when bile flow is impaired, and mice lacking UPR genes in their liver are highly susceptible to injury from bile duct obstruction. Now moving forward with the first human investigations examining UPR, Dr. Green aims to determine how it is activated in the bile ducts of patients with PSC. The team plans to study bile duct tissues obtained during endoscopic procedures performed for bile duct obstruction. The identification of “protective” genes and proteins could lead to new drug targets and, ultimately, the development of novel medical...
