Overview
We offer a one-year fellowship in motility training for eligible candidates. The programme offers training in the performance, analysis and reporting of esophageal and anorectal motility including biofeedback training. The program also offers exposure to high resolution colonic manometry. Fellows are exposed to patients with motility and functional GI disorders in clinics run by staff where they will learn strategies for the management of these patients and follow-up those that underwent motility testing here. The program also offers educational seminars on topics including the physiology of motility and the pathophysiology of specific motility disorders. Fellows will be exposed to a broad range of research activities ranging from clinical to basic scientific research ongoing in our laboratories. Faculty involved in this program include Dr. Stephen Collins, Dr. Premsyl Bercik, Dr. Jihong Chen and Dr. Kathryn Woodman. Eligible overseas candidates are welcome but expected to provide salary support from their native institutions.
Background
Gastrointestinal motility disorders encompass a range of conditions that include functional disorders such as irritable bowel syndrome and functional dyspepsia, disorders of esophageal motility including achalasia, reflux and esophageal spasm, as well as defecatory disorders, to more severe conditions such as gastroparesis and chronic idiopathic pseudo-obstruction. The motility laboratory at McMaster Medical Centre is equipped with high-resolution techniques for the routine assessment of esophageal, and anorectal function as well as biofeedback training. Patients seen in the laboratory are adults and if also children. High-resolution colonic motility is an emerging technology and is used occasionally to assess possible colonic failure in children and in adults.
Goals of Training
1. To become competent in the conduct, analysis and reporting of
gastrointestinal motility studies.
2. To understand the role of gastrointestinal motility testing in G.I. disorders with a particular emphasis on esophageal and functional G.I. disorders.
3. To undertake a research project relevant to the above-described objectives.
Expectations
Fellows will be expected to work in the motility laboratory to become competent in the performance and the evaluation of all routine motility studies.
Fellows will also be expected to work in the clinics of physicians with a specific interest in motility disorders and to become competent in the diagnosis and management of these conditions.
Fellows will be expected to participate in one or more research projects during the year. Projects range from clinical studies evaluating motility changes in conditions such as gluten sensitivity, or to the treatment of conditions such as intestinal pseudo-obstruction. Research conducted in the Farncombe Family Digestive Health Research Institute is translational in nature and focuses on the role of diet as well as the intestinal microbiota in determining GI motility in health and disease and involves preclinical and clinical research. The investigation of colonic motility in health and disease is another area of research at both the basic and clinical levels with the availability of high-resolution colonic manometry. Fellows will be expected to attend the weekly academic half-day offered by the academic division of gastroenterology at McMaster as well as the weekly seminar series offered by the Farncombe Family Digestive Health Research Institute.
Applications
The application deadline is November 1st annually.
Examples of publications
- De Palma G, Lynch MD, Lu J, Dang VT, Deng Y, Jury J, Umeh G, Miranda PM, Pigrau Pastor M, Sidani S, Pinto-Sanchez MI, Philip V, McLean PG, Hagelsieb MG, Surette MG, Bergonzelli GE, Verdu EF, Britz-McKibbin P, Neufeld JD, Collins SM, Bercik P. Transplantation of fecal microbiota from patients with irritable bowel syndrome alters gut function and behaviour in recipient mice. Sci Transl Med. 2017 Mar 1;9(379):eaaf6397. doi: 10.1126/scitranslmed.aaf6397. PMID: 28251905.
- Milkova N, Parsons SP, Ratcliffe E, Huizinga JD, Chen JH. On the nature of high-amplitude propagating pressure waves in the human colon. Am J Physiol Gastrointest Liver Physiol. 2020 Apr 1;318(4):G646-G660. doi:10.1152/ajpgi.00386.2019. Epub 2020 Feb 18. PMID: 32068445; PMCID: PMC7191456.
- Pinto-Sanchez MI, Hall GB, Ghajar K, Nardelli A, Bolino C, Lau JT, Martin FP, Cominetti O, Welsh C, Rieder A, Traynor J, Gregory C, De Palma G, Pigrau M, FordAC, Macri J, Berger B, Bergonzelli G, Surette MG, Collins SM, Moayyedi P, Bercik P. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Gastroenterology. 2017 Aug;153(2):448-459.e8. doi: 10.1053/j.gastro.2017.05.003 PMID: 28483500.
- Chen JH, Parsons SP, Shokrollahi M, Wan A, Vincent AD, Yuan Y, Pervez M, Chen WL, Xue M, Zhang KK, Eshtiaghi A, Armstrong D, Bercik P, Moayyedi P, Greenwald E, Ratcliffe EM, Huizinga JD. Characterization of Simultaneous Pressure Waves as Biomarkers for Colonic Motility Assessed by High-Resolution Colonic Manometry. Front Physiol. 2018 Sep 20;9:1248. doi: 10.3389/fphys.2018.01248. PMID: 30294277
- Pinto-Sánchez MI, Nachman FD, Fuxman C, Iantorno G, Hwang HJ, Ditaranto A, Costa F, Longarini G, Wang XY, Huang X, Vázquez H, Moreno ML, Niveloni S, Bercik P, Smecuol E, Mazure R, Bilder C, Mauriño EC, Verdu EF, Bai JC. Altered Esophageal Mucosal Structure in Patients with Celiac Disease. Can J Gastroenterol Hepatol. 2016;2016:1980686. doi: 10.1155/2016/1980686. PMID: 27446827; PMCID: PMC4904646
- Reed DE, Pigrau M, Lu J, Moayyedi P, Collins SM, Bercik P. Bead study: A novel method to measure gastrointestinal transit in mice. Neurogastroenterol Motil. 2014 Nov;26(11):1663-8. doi: 10.1111/nmo.12442. Epub 2014 Sep 27. PMID:25264134.
Funding
Limited internal funding is available, but candidates are encouraged to apply for external funding or to provide their own funding from their parent institutions.