Utility of motility-MRI in the assessment of foregut neuromuscular function in children with intestinal pseudo obstruction.

Paediatric intestinal pseudo-obstruction (PIPO) encompasses a group of rare severe disorders affecting the gastrointestinal nerves and muscles. The inability to tolerate feeds is one of the main problems in children with PIPO, representing a considerable psychological burden for both children and their families. Tools able to predict the optimisation of oral/intestinal nutritional support are scarce. Moreover, the availability of specialist equipment used for the diagnosis and management is limited to a few centres. Recent advances in motility magnetic imaging (mMRI) suggested its potential use as a non-invasive technique for quantifying intestinal motility in children with PIPO.

The study aims to demonstrate the utility of mMRI for assessing bowel movement by using a novel software to quantify objectively segmental and global gut motor activity in the response to a liquid challenge. By comparing mMRI biomarkers to parameters detected by antro-duodenal manometry and small bowel scintigraphy, the current diagnostic tools used for assessing the bowel motor activity. They aim to provide new insights on the underlying mechanisms responsible for the disease severity. They also aim to provide a proof of concept for the use of mMRI as a non-invasive diagnostic tool for the diagnosis and management of children with PIPO. This study will be led by Dr Osvaldo Borelli, Paediatric Consultant Gastroenterologist, Great Ormond Street Hospital. The study is being funded by PORT at a cost of £50,000.