Principal Investigator: Dustin Carlson, MD; Co-Principal Investigator: Erica Donnan, MD In 2017, more than 191 million opioid prescriptions were dispensed in the United States. Opioids frequently cause many gastrointestinal side effects such as bloating, reflux and constipation, yet not much is known about how opioids affect the esophagus and swallowing. Opioids can lead to symptoms that mimic esophageal disorders such as achalasia that could result in unnecessary invasive procedures including surgery. The largest study of its kind, this project will look into how opioids affect esophageal motility. Using the Esophageal Center of Northwestern’s motility registry, Drs. Carlson and Donnan have access to some 4,000 patients who have undergone high-resolution manometries to assess esophageal function. The team will look at patients who have had motility studies at Northwestern while on opioids and evaluate volunteer patients on opioids without swallowing symptoms. Given the widespread use of opioids, patients with opioid- induced swallowing problems will become more common. This study is essential in determining how opioids affect the esophagus so that clinicians can correctly evaluate and treat these...
Principal Investigator: Emanuelle Bellaguarda, MD; Co-Principal Investigator: Stephen B. Hanauer, MD Inflammatory bowel disease (IBD) often affects people in their reproductive years, with little known about the impact of anti-inflammatory and immunosuppressive therapies on reproductive health. Men with IBD and their partners often request information on the effect of medication on male fertility. Fears and doubts significantly affect family planning as well as impact adherence to drug treatment and disease control. Fertility concerns emphasize the need to investigate the safety of drug treatment in these patients. Investigating the impact of two novel IBD treatments on sperm quality and genetic structure in male patients, Dr. Bellaguarda hopes to improve future patient care by ultimately enhancing patient counseling. Her team at Northwestern Memorial Hospital has joined forces with Aarhus University Hospital in Denmark to take advantage of the expert knowledge in the different centers within reproduction, medical treatment in IBD, and drug...
Principal Investigator: Aziz Aadam, MD; Co-Principal Investigator: Kevin Liu, MD Gastroparesis is a condition when the stomach does not empty correctly due to lack of stomach muscle coordination. Many patients with chronic gastroparesis experience symptoms ranging from persistent nausea and vomiting to the inability to eat or drink. Lacking effective treatment options, patients with gastroparesis are at risk for inadequate nutrition and repeated hospitalizations. Endoscopic targeted therapies including placement of a tube to allow the stomach to empty into the small intestine (transpyloric stent) and G-POEM, an advanced minimally invasive procedure to cut the sphincter muscle in the pylorus, have recently shown promise by improving gastric emptying for patients. The Aadam team intends to examine whether patients who improve with transpyloric stenting, which provides temporary relief, will also demonstrate improvement with G-POEM, which can provide a more durable, long-lasting solution. Northwestern is one of the few centers in the nation performing G-POEM and has one of the highest volumes for both advanced endoscopic therapies. This study offers great potential for significantly impacting this patient...
Principal Investigator: Lisa B. VanWagner, MD The portal vein carries blood from digestive organs to the liver. Portal hypertension occurs when pressure increases within this vein due to blockage in blood flow through the liver. Cirrhosis, or scarring, of the liver is the most common cause. This condition often results in fluid build-up in the abdomen and bleeding from veins in the esophagus that can impair quality of life and even lead to death due to intestinal bleeding or infection. An artificial shunt procedure known as TIPS (transjugular intrahepatic portosystemic shunt) helps reduce portal hypertension. It works by connecting two veins: the portal vein that carries blood from the digestive organs to the liver and the hepatic vein that carries blood from the liver to the right part of the heart. While the lifesaving procedure may cause heart failure in some patients because of increased blood flow directly to the heart, others experience improvement in heart function. However, predicting outcomes for these patients is currently unknown. Dr. VanWagner’s study aims to better understand changes in heart function after a TIPS procedure to better intervene and prevent heart failure in these at-risk...
Principal Investigator: Daniel Ganger, MD; Co-Principal Investigator: Justin R. Boike, MD Chronic liver disease remains a significant burden on society, despite the ability to treat and cure hepatitis C. With the growing obesity epidemic in the United States, fatty liver disease will soon overtake hepatitis C as the primary cause of chronic liver disease and cirrhosis. While liver transplantation offers a cure, it is not an option for many individuals who face complications of cirrhosis such excessive fluid retention and internal bleeding. Transjugular intrahepatic portosystemic shunt (TIPS) procedures offer an effective tool for treating these complications. In some patients, though, TIPS can worsen liver failure and sometimes cause debilitating confusion called hepatic encephalopathy. It is believed that excessive shunting of blood flow from the liver may be the culprit. In this study, the researchers will study the ability of a new laboratory test to measure the percentage of blood shunted away from the liver to better predict those patients at greatest risk for hepatic encephalopathy after a TIPS procedure. This tool could dramatically help guide the use of TIPS and promote earlier use of TIPS in low-risk...
