We have recently published work (supported by the foundation) in June of this year highlighting the outcomes from one of our studies undertaken by Hazel Duncan clinical and research dietician.
Children and young people with Crohn’s disease can have problems gaining enough weight and a small number can require a long term feeding tube to be placed to help them gain weight. In the short term we use nasogastric tubes but longer term these children should have a gastrostomy inserted. There is not much research assessing the implications on growth in these patients and therefore we decided to review the progress our patients had made using gastrostomies and publish the results.
Between 2003 and 2010 we had 16 patients with Crohn’s disease who had had a gastrostomy placed, 9 of the 16 reported temporary complications which resolved in a month and only one patient reported long term complications. We looked at growth improvement from time of insertion until 2 years following insertion and found that there was a marked improvement in their weight and body mass index (BMI)scoring 1 year later. An improvement in height after 2 years was also found. We also looked at the type of feed used and the volume each patient had.
From the results of our study we know that for patients with Crohn’s disease gastrosotmy tubes are very useful to promote weight gain and improve growth outcomes. This is important for patients who may be struggling to achieve adequate nutrition through their diet alone. We also can now provide reassurance to families and patients that insertion of gastrostomies in patients with crohn’s disease is both safe and effective.
The full journal article Duncan H, Painesi A, Buchanan E, McGrogan P, Gerasimidis K, Walker G, Haddock G, Russell RK. Percutaneous endoscopic gastrostomy placement in paediatric Crohn’s disease patients contributes to both improved nutrition and growth. Acta Paediatrica 2018;107(6):1094-1099. Thanks again for the support and if anyone has any further questions or queries then please contact hazel or any member of the IBD team.
Hello everyone! My name is Rachel Harris and I am the new Clinical Research Fellow in Paediatric Gastroenterology working between the Clinical Research Facility and the Royal Hospital for Children, Glasgow and am the 3rd Catherine McEwan fellow.
I am a junior doctor and after completing a placement within the paediatric gastroenterology department here at RHC in 2016 I loved my team so much I just had to come back! I currently split my time 50/50 between being a ward doctor looking after the gastroenterology inpatients and conducting various research activities from the Clinical Research Facility. We are so lucky to work within such a fantastic team of doctors, nurses, specialist nurses, dieticians, AHPs and ward staff – not to mention of course our amazing patients! I am really enjoying my new post and am incredibly grateful to the Catherine McEwan Foundation for the opportunity my role is giving me to develop my skills and interests in both research and paediatrics.
What We’ve Been Working on So Far
There are currently lots of exciting research projects going on within the IBD team here at the Royal Hospital for Children which we hope will make a positive impact on our patients present and future. Recently I have been working alongside Lisa the research nurses on a new European wide Inception Cohort and safety registry; this will collect information on a 1000 new IBD patients at diagnosis in Europe and follow how they do after diagnosis. This will assess the effectiveness of current treatment plans in patients with IBD and how this relates to their symptoms and outcome. Thanks to the support we have been able to recruit many of the recently diagnosed patients into this study making sure patients from RHC will be well represented in this large and important study. Our team are also hoping to commence a randomised control trial looking at the drugs we use for maintenance of remission in patients with newly diagnosed Crohn’s disease very soon.
Now I have found my feet I am also working on several other studies including a study analysing the factors which may predict and affect treatment outcomes for patients with severe IBD (infliximab levels in IBD patients), complications from treatment with IV iron treatment and how to prevent these in future, plus outcomes and complications for pouch surgery for Ulcerative Colitis. I am also assisting in studies looking at the impact of exercise in IBD and bone health in IBD patients assessed by MRI.
The research undertaken within the paediatric gastroenterology team at RHC will undoubtedly be invaluable in helping clinical teams understand IBD better and develop new treatment strategies for the future; and this work would not be possible without the Catherine McEwan foundation – so thank you once again for all of your support!
Dr Rachel Harris (3rd Catherine McEwan Fellow) July 2018