Gastroenterology research

About our research

Our integrated team of gastroenterology researchers, nurses and clinicians are at the forefront of gastroenterology research in the UK.

Research into inflammatory bowel disease (IBD) is a major strength across King’s Health Partners (KHP), bringing together several independently successful research groups: immunology, genetics, dieticians, psychiatry and clinical IBD.

We have an international reputation as leaders and pioneers of optimised immunosuppression trials looking into IBD using pharmacogenetics (the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs).

Researchers at Guy's and St Thomas' have also conducted research looking into new drug targets – which has shaped IBD practice across the globe (Taylor Nat Rev Gastroenterol Hepatol 2011, Heap Nature Genetics 2014). Together we are developing precision medicine approaches to improve patient care through several research trials.

If attending one of the outpatient clinics, please be aware that you may be invited to take part in one of our current studies. If you would like more information on any of the studies, please email us at gastroenterologyresearch@gstt.nhs.uk.

The Biomedical Research Centre patient and public involvement advisory group (PPIAG) develops methods of engagement with the local population. They also provide a patient/public perspective on a variety of research practices and approaches.

Current research studies

We are currently looking for volunteers to take part in the following studies.

Click on the headings below to find out more about each study and see if you might be eligible to take part and help us with our research.

  • IBD Genetics (IBDGen)

    The inflammatory bowel diseases (IBD) comprise Crohn’s disease (CD) and ulcerative colitis (UC). These are lifelong conditions which cause ulceration and inflammation in the gut, commonly first presenting in patients’ teens and twenties. These diseases are common, affecting approximately 1 in 200 people in the United Kingdom. Some people have a genetic predisposition which means they have an increased risk of developing IBD and which determines the pattern and severity of the disease. To date more than 90 IBD genes have been identified.

    The UKIBD Genetics Consortium (UKIBDGC) comprises clinicians and scientists with a track record of successful collaborative research in the genetics of inflammatory bowel disease. Our aims are to identify and understand the genes that determine disease susceptibility, course and response and side effects of treatment.

    We are asking all of our patients who have IBD, for example Crohn's disease or ulcerative colitis, whether they would be happy to complete a two-page questionnaire with a researcher and give a blood or saliva sample, so that we can study the genetics of IBD.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study in clinics.

  • Orofacial granulomatosis

    In some individuals Crohn’s disease affects the mouth causing cracked swollen lips and painful oral ulceration. This rare form is sometimes referred to as orofacial granulomatosis or OFG.

    There are two types of the disease; OFG that affects patients who also have Crohn’s, and OFG that affects patients who don’t have Crohn’s.

    We are recruiting volunteers with both types of OFG to investigate its genetic causes to see if they overlap with the genetic risk factors for the intestinal form of Crohn’s disease. We are also exploring whether microbial changes in the saliva of OFG patients are associated with disease or the onset of intestinal Crohn’s.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study in clinics.

  • UK IBD BioResource

    Recent years have seen major advances in understanding the causes of Crohn’s disease and ulcerative colitis. This particularly relates to their genetic basis, and how gene variants affect the immune system of people who develop IBD. The key challenge now is to translate this new knowledge into new treatments, and use it as a platform to drive towards a cure for IBD. This is where the UK IBD BioResource comes in – allowing scientists and researchers to access groups of patients with Crohn’s or colitis who have uniform genetic make-up or clinical features, so that they can ask very focused questions relating to disease mechanisms and potential new treatments.

    Patients with IBD will be asked to donate a blood sample for DNA and serum analysis and fill in health and lifestyle questionnaire.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • Defining Immune Pathways

    A number of chronic conditions have been associated with gut inflammation, including coeliac, inflammatory bowel diseases (IBD) (ulcerative colitis, Crohn’s disease), metabolic disorders (obesity, diabetes), chronic liver conditions (including autoimmune diseases and non-alcoholic fatty liver disease) and graft versus host disease (GvHD, a complication of bone marrow transplantation).

    Despite the recent advantages in the understanding of genetics, the mechanisms behind gut damage remain unexplained. This limited understanding is reflected in the limited treatment options available for these conditions.

    The development of cutting edge techniques in experimental immunology have provided researchers with the opportunity to understand the components of the inflammatory response. With this study we hope to use these techniques to define the different pathways driving gut inflammation.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • Gut bacteria in Colorectal Cancer

    The human gut is lined with a thick layer of bacteria called the gut microbiome. Changes in the microbiome have been linked to several diseases including cancer. This study will look at the effects of some of the toxins produced by gut bacteria on colorectal cancer development.

    Patients will undergo a colonoscopy where samples from the bowel lining will be obtained. Samples will be collected from patients:

    1. with a new diagnosis of colon cancer
    2. with large non-cancerous growths known as polyps
    3. who have had colon cancer removed and are undergoing follow up colonoscopy
    4. with chronic inflammatory conditions of the bowel who are undergoing routine check-up colonoscopy
    5. with a healthy bowel used as 'controls'.

    Blood and stool samples will also be collected from selected participants. The sample collection will be undertaken in the endoscopy department at Guy's and St Thomas’ hospitals.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • SPARE

    The SPARE study is a randomised controlled trial comparing combination therapy (the use of multiple drugs) to monotherapy (the use of a single drug only) in Crohn’s disease patients. The aim of this study is to show that infliximab therapy (with or without other drugs such as mercaptopurine, azathioprine, methotrexate) is superior to just those drugs alone to maintain sustained steroid-free remission over two years.

    The main end point of the study is clinical relapse rate at two years. The study is sponsored by NHS Lothian and hopes to recruit 300 patients overall.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • Food-related quality of life in inflammatory bowel disease

    Food is an important part of people's lives. It can be a source of pleasure, a method of coping and an important means of social interaction. Previous research has shown that these experiences can be different in people with inflammatory bowel disease (IBD), as many feel excluded from social interactions involving eating and drinking, some limit the amount of food consumed, and some feel stressed and anxious due to uncertainty of the impact of eating on bowel function. However, we do not know how many people are affected by these problems, what the most common problems are, or why and when they occur. More importantly, we do not know how to help people affected by these problems.

    Aims of this two phase study

    • Phase 1 – measure the extent and type of problems with food-related quality of life in people with IBD. A national survey will be undertaken with 1,525 people with IBD. They will be asked to complete the food-related questionnaires. This will allow us to calculate how many people experience food-related problems, what the most common problems are, and what affects their severity.
    • Phase 2 – involve people with IBD in developing tools to help others address these problems. People with IBD who have experienced problems of food-related quality of life and have successfully addressed them will be invited to take part. We will start by understanding the potential approaches to addressing the problems from the perspective of patients and health professionals. Then joint patient/health professional meetings will take place with the use of film/audio ‘patient stories’ so that all involved can understand what the issues are and how best to resolve them. The tools to help address food-related quality of life in IBD will be developed in a series of up to five meetings.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • The Flora colonoscopy twin study: genetic transmission of components of the human microbiome

    The human gut is lined with a thick layer of bacteria called the gut microbiome. Most of the bacteria in the human microbiome have benefits for the body, including protection from pathogens and enhanced nutrition. However, there is evidence that changes in the microbiome are associated with some chronic illnesses involving the gut. There may also be links between people’s genetics and their microbiome, suggesting that the microbiome may have a heritable component.

    This study aims to look at the differences in the structure of the microbiome and to understand the biological processes that link the microbiome to its host. We are already doing this using microbiome samples from the faeces, skin, nose and mouth in the cohort participating in the flora twin study. We intend to extend this work in a subset of this cohort (100 twin pairs) by looking at the genetic composition of the microbiome in samples from several sites inside the gut taken by colonoscopy.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • Predicting serious drug side effects in gastroenterology (PRED4)

    This is a study for patients who have inflammatory bowel disease (IBD), for example Crohn's disease or ulcerative colitis, who have taken any of the following medicines and experienced any of the accompanying side effects. We are asking all of these patients whether they would be happy to answer some questions and give a blood sample.

    1. Azathioprine or Mercaptopurine – the side effects that we are studying are joint pain, muscle pain, fever, problems with the liver, problems with the white blood cells inflamed pancreas 
    2. Infliximab or Adalimumab – the side effect that we are studying is a problem with the brain and spinal cord (demyelination).
    3. Sulfasalazine – the side effect that we are studying is a problem with the white blood cells (neutropenia).
    4. Proton pump inhibitors (for example Omeprazole and Lansoprazole) – the side effect that we are studying is a problem with the kidneys (interstitial nephritis).

    For more information, visit the UKIBD Genetics Consortium (UKIBDGC) website or email gastroenterologyresearch@gstt.nhs.uk.

    We will approach eligible patients to take part in this study.

  • The UK Vedolizumab real life experience study in inflammatory bowel disease (VEST)

    Vedolizumab has been recently licensed for use in the management of ulcerative colitis (UC) and Crohn's disease (CD).

    This study aims to capture the experience of this new therapy across the UK. All adult patients treated with Vedolizumab will be eligible for the study. Patients will complete a number of simple questionnaires whilst they have their Vedolizumab infusions during their first year of treatment. Teams will record data including details of the patient's IBD such as characterisation of their disease, medications, previous history and blood tests that are taken part of the patient’s routine clinical data.

    For more information, please email gastroenterologyresearch@gstt.nhs.uk.

    We will be approaching patients to take part in selected clinics.

Previous studies

Read about past studies. Please note we are no longer recruiting volunteers for these trials.

  • Faecal Incontinence iNtervention Study (FINS)

    We asked a selection of our patients who have inflammatory bowel disease (IBD), for example Crohn's disease or ulcerative colitis, whether they experience faecal incontinence (uncontrollable passing of poo) via a quick two-page questionnaire completed with a research nurse or sent in the post.

    For selected participants, a self-management tool and advice from IBD clinical nurse specialists was offered to them, aiming to improve their experience with faecal incontinence.

    For more information, please visit the ClinicalTrials.gov website  or contact the principal investigator of the study Julie Duncan at julie.duncan@gstt.nhs.uk.

     

  • Quality of Life Tool for IBD

    This study explored the acceptability of an intervention manual to patients. The cognitive-behavioural therapy (CBT) inspired manual contained several chapters. Each chapter addressed a different topic with information, guidance in setting goals for behaviour change and accompanying tasks to aid implementation.

  • Personalised Anti-TNF Therapy in Crohn’s disease (PANTS)

    We asked a selection of our patients who have inflammatory bowel disease (IBD), for example Crohn's disease or ulcerative colitis, taking the medicines infliximab or adalimumab, whether they would like to take part in a long-term study looking at how well they respond to these medicines. Participation required meeting periodically with a research nurse and answering questions and giving blood and stool samples.

    Find out more information about the PANTS project.

Researchers

  • Dr Bu’ Hayee, clinical lead for gastroenterology, King's College
  • Dr Peter Irving, consultant gastroenterologist, Guy's and St Thomas' Hospital
  • Dr Natalie Prescott, Wellcome Trust University award research fellow, medical and molecular genetics department, King's College London
  • Dr Tony Marinaki, faculty of life sciences and medicine department
  • Professor Christopher Mathew, head of complex disease genetics group, genetics and molecular medicine department, King's College London
  • Dr Nick Powell, Wellcome Trust intermediate clinical fellow, King's College London, honorary consultant in gastroenterology, Guy's and St Thomas' Hospital
  • Professor Jeremy Sanderson, consultant gastroenterologist, clinical director, gastrointestinal medicine and surgery, Guy's and St Thomas' Hospital
  • Professor Jo Spencer, professor of experimental medicine, King's College London

External information

Useful links to other sites that may be of interest.

Patient services

Take part in a clinical trial

Find out how you can take part in a clinical trial at Guy’s and St Thomas’ and what is involved.