Neuro-gatroenterology and Motility

Focus Areas of Research

  • Visceral pain
  • Gut-Brain-axis
  • Multimodal sensory testing and visceral hypersensitivity
  • Segmental or whole gut motility
  • Experimental models of opioid induced bowel dysfunction (OIBD)
  • Sphincter evaluation

Functional gastrointestinal disorders are commonly encountered in clinical practice, and pain is their most common presenting symptom. In addition, patients with these disorders often demonstrate visceral pain hypersensitivity, which is important in the underlying pathophysiology. The gut-brain axis consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions. In Mech-Sense we have developed the multi-modal oesophageal and multi-modal rectal probe, where mechanical, electrical, thermal and chemical stimulations can be achieved and sensory responses to these stimuli can be determined. Such experimental multimodal stimulation in different gut segments has the advantage of involving distinctive receptors, various sensory nerves and different pain pathways mimicking clinical pain that favors investigation of central pain mechanisms involved in allodynia, hyperalgesia and viscero-somatic or viscero-visceral pain referrals.

Segmental or whole gut motility patterns are assessed with the wireless motility capsule (SmartPill) or the 3D-Transit system, from which transit times, pH profiles, different motility indices and retrograde movements can be derived. These measures are valuable tools in measuring and interpreting the impact of different pharmacolocical treatment on gut motility (such as OIBD) and pathophysiological alterations. Finally the endo-FLIP is used to evaluate oesophageal and anal sphincter function.

Responsible Researcher

Professor Christina Brock, DMV, PhD

Selected Publications

  1. Drewes AM & Gregersen H. Multimodal pain stimulation of the gastrointestinal tract, World J Gastroenterol. 2006
  2. Nissen TD, Brock C, Graversen C, Coen SJ, Hultin L, Aziz Q, Lykkesfeldt J, Drewes AM. Translational aspects of rectal evoked potentials: a comparative study in rats and humans Am J Physiol Gastrointest Liver Physiol. 2013
  3. Lottrup C, Olesen SS, Drewes AM: The Pain System in Oesophageal Disorders: Mechanisms, Clinical characteristics, and Treatment. Gastroenterol Res Pract. 2011
  4. Brock C, Nissen TD, Gravesen FH, Frøkjaer JB, Omar H, Gale J, Gregersen H, Svendsen O, Drewes AM. Multimodal sensory testing of the rectum and rectosigmoid: development and reproducibility of a new method. Neurogastroenterol Motil. 2008
  5. Brock C, Andresen T, Frøkjaer JB, Gale J, Olesen AE, Arendt-Nielsen L, Drewes AM. Central pain mechanisms following combined acid and capsaicin perfusion of the human oesophagus. Eur J Pain. 2010
  6. Lelic D, Nissen TD, Brock C, Aziz Q, Drewes AM. Rapid balloon distension as a tool to study cortical processing of visceral sensations and pain. Neurogastroenterol Motil. 2015 Jun
  7. Brock C, Olesen SS, Olesen AE, Frøkjaer JB, Andresen T, Drewes AM. Opioid-induced bowel dysfunction: pathophysiology and management. Drugs. 2012
  8. Grønlund D, Poulsen JL, Sandberg TH, Olesen AE, Madzak A, Krogh K, Frøkjaer JB, Drewes AM. Established and emerging methods for assessment of small and large intestinal motility. Neurogastroenterol Motil. 2017
  9. Farmer AD, Pedersen AG, Brock B, Jakobsen PE, Karmisholt J, Mohammed SD, Scott SM, Drewes AM, Brock C. Type 1 diabetic patients with peripheral neuropathy have pan-enteric prolongation of gastrointestinal transit times and an altered caecal pH profile. Diabetologia. 2017
  10. McMahon MP, Drewes AM, Gregersen H: Functional oesophago-gastric junction imaging. World J Gastroenterol. 2006