LIMR Clinical: Gastroesophageal reflux in respiratory disease: pathogenic role and improved management

Summary

Gastroesophageal reflux disease (GERD) is a condition in which stomach contents, such as food and acid pass into the gullet/oesophagus causing heartburn. GERD is very common in patients with lung disease, such as idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD) and cystic fibrosis (CF). In some patients with lung disease, reflux can be substantial, leading to concerns that the stomach contents might be passing all the way up the gullet into the lungs (‘aspiration’), causing or worsening the lung disease. Reflux and aspiration can continue to be a problem following lung transplantation.

The University of Leeds, together with the Mayo Clinic, USA are carrying out an extensive research program to better understand the mechanisms responsible for reflux and possible aspiration in patients with lung diseases and following transplantation. The research program is also examining how reflux relates to the severity of lung disease and its progression, and how best to treat.

You will be part of an international research team of world experts, clinicians/doctors and scientists from the University of Leeds, Leeds Teaching Hospital NHS Trust (LTHT), and the Mayo Clinic, USA. You will work with patients from clinics at LTHT, perform the oesophageal and pulmonary function tests (after appropriate training), analyze test data acquired from both Leeds and Mayo Clinic, carry out statistical analysis and help prepare both original publications and abstracts to be presented at both national/international conferences. The project is particularly suited to medically qualified doctors, who wish to develop their research portfolio and continue these research interests into their clinical practice, but also to scientists with an interest in clinical research. Particular aspects of this research program will be tailored to whether you are a clinician and/or scientist, with the possibility of us recruiting both a clinician and a scientist. Previous experience, although desirable, not essential.

Techniques associated with this project

Oesophageal function tests, such as High Resolution Impedance Manometry and 24-hr pH-impedance, and analysis of these tests using the Chicago Criteria (training will be provided). Pulmonary function testing (training will be provided). Depending on whether medically trained and successful registration with the General Medical Council, other techniques may include bronchoscopy, collection of bronchoalveolar lavage fluid and sputum. Statistical analysis and preparation of scientific papers for successful publication in international medical journals.

This project is available as part of the International PhD Academy: Medical Research

References

Houghton LA, Lee AS, Badri H, DeVault KR, Smith JA. Respiratoy disease and the oesophagus: reflux, reflexes and microaspiration. Nature Reviews Gastroenterology and Hepatology 2016; 13: 445-460

Tangaroonsanti A, Lee AS, CrowellMD, Vela MF, Jones DR, Eramus D, Keller C, Mallea J, Alvarez F, Almansa C, DeVault KR, Houghton LA. Impaired esophageal motility and clearance post-lung transplant: risk for chronic allograft failure. Clin Transl Gastroenterol 2017; 8: e102 doi 10.1038/ctg.2017.30

Tangaroonsanti A, Vela MF, Crowell MD, DeVault RK, Houghton LA. Esophageal dysmotility according to Chicago classification v3.0 vs v2.0: Implications for association with reflux, bolus clearance, and allograft failure post-lung transplantation. Neurogastroenterol Motil 2018; 30(6): e13296 doi 10.1111/nmo.13296. Epub 2018 Feb 7

In line with the bespoke nature of our International PhD Academy a modified PhD project can be proposed dependent on students interests and background.

A degree in biological sciences, dentistry, medicine, midwifery, nursing, psychology or a good honours degree in a subject relevant to the research topic. A Masters degree in a relevant subject may also be required in some areas of the Faculty. For entry requirements for all other research degrees we offer, please contact us.

Applicants whose first language is not English must provide evidence that their English language is sufficient to meet the specific demands of their study. The minimum requirements for this programme in IELTS and TOEFL tests are: • British Council IELTS - score of 7.0 overall, with no element less than 6.5 • TOEFL iBT - overall score of 100 with the listening and reading element no less than 22, writing element no less than 23 and the speaking element no less than 24.