The Effect of Transjugular Intraheptic Portosystemic Shunt (TIPS) on Gastrointestinal Motility and the Gut Microbiota



Status:Recruiting
Conditions:Gastrointestinal
Therapuetic Areas:Gastroenterology
Healthy:No
Age Range:18 - 99
Updated:7/27/2018
Start Date:November 2016
End Date:November 2019
Contact:Simone Rainey
Email:Simone.Rainey@nyumc.org
Phone:212 263 2710

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The effect of portal hypertension on gastrointestinal motility, and how reversal or
improvement in portal hypertension may alter gastrointestinal motility, remains unclear and
further research is needed. Additionally, patients with cirrhosis have altered gut
microflora, particularly rich in lactobacilli, including enterococci and bifidobacteria.
Transjugular Intraheptic Portosystemic Shunting (TIPS) is a procedure performed by
interventional radiologists, in which a connection is made between the portal and venous
circulations, allowing high pressure portal blood to more easily enter the systemic
circulation and bypass the liver; thus effectively decreased portal pressure.


Inclusion Criteria:

- Patients with either radiographic or biopsy proven decompensated cirrhosis (as
determined by ascites, variceal hemorrhage, encephalopathy or jaundice).

- Patients undergoing an elective TIPS for any standard of care established indication
(examples: worsening ascites, recurrent variceal bleeding).

Exclusion Criteria:

- Pregnant women.

- Patients unwilling or unable to provide informed consent.

- Patients undergoing an emergent TIPS for acute or subacute variceal hemorrhage.

- Patients with diabetes, significant cardiovascular, renal or other chronic disease
which has been known to affect intestinal motility.

- Previously diagnosed gastroparesis or other GI dysmotility disorder.

- Patients currently taking narcotics, antibiotics excluding rifaximin, prokinetic
medications or lactulose.

- Patients with a history of gastric bezoar.

- Patients with a history of multiple intestinal surgeries or GI surgery within the past
3 months.

- Patients with a history of gastrointestinal strictures, fistulas, or physiological or
mechanical obstruction.

- Patients with a history of gastrointestinal strictures, fistulas, or physiological or
mechanical obstruction.

- Patients with a history of gastrointestinal strictures, fistulas, or physiological or
mechanical obstruction.

- Patients with a history of diverticulitis.

- Patients with swallowing disorders and increased risk of aspiration (such as prior
history of aspiration).

- Patient with Celiac disease.

- Patients with implanted or portable electro-mechanical medical devices.
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(212) 263-7300
Principal Investigator: Akhilesh Sista, MD
Phone: 212-263-2710
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