A paediatric surgery trainee at the Royal Sick Children’s Hospital, Yorkhill, has been awarded £30,000 to carry out research at the University into bowel problems in children with cerebral palsy.

Mairi Steven who works with Robert Carachi, Professor of Surgical Paediatrics at Glasgow, was awarded the Ritchie Fellowship earlier this month.Mairi Steven

Ms Steven’s project aims to understand why children with cerebral palsy are prone to problems such as vomiting and retching, know clinically as “foregut dysmotility”.  This means that a patient’s stomach may not empty as normal leading to vomiting and feed intolerance. To alleviate symptoms, many children must undergo surgery. However, not all surgical intervention is successful and in some instances, it can cause serious complications. 

Over the next three years, Ms Steven will work with Prof Carachi and Dr Simon Milling, of the Institute of Infection, Immunity and Inflammation and researchers from Newcastle University to develop an animal model of foregut dysmotility in cerebral palsy. An experimental treatment for the condition will also be tested. 

The research project arises, in part, from clinical observations made by those in the Department of Pediatric Surgery at Yorkhill.

Ms Steven explains:  “We have noticed that patients’ symptoms improve following a celiac plexus block and thoracoscopic splanchnectomy - procedures which blockade or remove specific nerve fibres innervating the stomach and small intestine respectively. This minimally invasive or “keyhole” procedure may be a new way of managing foregut dysmotility in children with cerebral palsy.

“As yet, we have no scientific basis for the improvements we have seen, we simply have a hypothesis that the condition stems from an imbalance in the interplay between the sympathetic and parasympathetic nervous systems.

“This is what we will now test by using an animal model. Clinically, if our hypothesis proves to be correct, the use of small bowel transplant for children with severe dysmotility disorders will no longer be the only surgical option and it may provide the scientific proof needed to endorse the use of celiac plexus block or thoracic splanchnectomy for such patients. 

“We hope that our work will be able to help us deliver better treatment and care in future which will greatly improve the quality of these children’s lives and those of their carers.”

First published: 11 March 2011

<< Mar