Clinical Research Studies

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. In order to show that decreased gastrointestinal motility seen in cirrhotic patients is a function of portal hypertension, and that gut motility in post-TIPS patients is significantly improved compared with cirrhotic patients pre-TIPS, patients will be identified as those who are scheduled to undergo an elective TIPS for performed for established indications. Each patient will undergo a pre- and post-TIPS assessment of motility with a Smartpill® study, which will be read and confirmed by two separate blinded gastroenterologists trained to interpret motility studies. Patients will be brought back at 12 weeks after TIPS procedure for the post-TIPS SmallPill® study (FDA approved device).