Computer Cooling Technology To Help Diagnose Digestive Disorders

Main Category: GastroIntestinal / Gastroenterology
Also Included In: IT / Internet / E-mail
Article Date: 17 Jun 2009 - 5:00 PDT

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Some things in life are multi-purpose. Now miniature technology used to cool the central processing units in computers may have found a use in mainstream medicine!

Temperature-controlling "Peltier technology" is set to help doctors give a quicker diagnosis of people who suffer with acid-related disorders of the stomach.

Over seven million adults in the UK - up to 15% of the UK's total adult population - suffer with digestive disorders of the oesophagus. Now they stand to benefit as researchers develop the technology which prides itself on precise heating and cooling and accurate temperature control. Oesophageal disorders range from reflux, chronic heartburn to aggressive oesophagus cancer.

How would the gadget work? The miniature device when complete, would act a bit like a thermometer, once inserted into the patients' oesophagus (gullet) it would investigate changes to the thermal sensitivity of tissue. It could help identify those patients with abnormal acid exposure in the gullet who have heightened sensitivity in specific nerves which respond to acid. And it would also be used to measure a patient's sensory response to thermal stimulation in their oesophagus. This would then be used to determine their level of sensitisation and to guide response to therapy.

Once doctors have all this information, they will be in a much better position to treat the problem as tissue temperature can be a key feature of digestive disorders.

Scientists at The Royal London Hospital, Whitechapel, east London are adapting the computer cooler with the help of a £113,000 two-year Healthcare Scientist Research Fellowship grant awarded by the Chief Scientific Officer for England (CSO) and managed by the National Institute for Health Research.

Healthcare scientist, Dr Jonathan Reeves from The Royal London's Clinical Physics Clinical Academic Unit is working in collaboration with the team from neurogastroenterology.

Dr Reeves said:

"Typically, Peltier technology is used to cool high performance components in computers so people may be surprised to hear that we are using this technique to help diagnose disorders of the oesophagus. There is no comparable existing product that provides the fine control and rapid changes in temperature that this technology delivers.

"Acid-related digestive disorders of the stomach are a burden on patients, the NHS, and society in general because they are highly prevalent, have varied signs and symptoms, and are costly to treat.

"By the end of the two years, we hope to have a tested thermal device ready to be trialled within a large scale clinical study.

"Unfortunately, current conventional tests do not always result in a definitive diagnosis or explanation of a patient's symptoms. What we need is new sensory testing techniques to better understand the underlying mechanisms of oesophageal pain. "

Prototypes will be developed to enable easy insertion into the patient's oesophagus. The current prototype device has a diameter of only 7mm.

Professor Qasim Aziz, Professor of Neurogastroentorology at The Royal London Hospital, explained:

"While there are excellent drugs currently available that can suppress acid secretion from the stomach and hence reduce symptoms in patients with acid reflux in the gullet, a proportion of patients fail to respond to this treatment. Current theories suggest that failure to respond to standard therapy may be due to the fact that repeated acid reflux has now caused increased sensitivity of the nerves in the lining of the gullet so that these nerves are activated even by small amounts of acid which would be considered normal.

"Currently it is difficult to determine if the nerves in the gullet have become sensitised or not. We know that nerves that respond to acid also respond to changes in temperature. However, thus far it has been difficult to devise methods for stimulating these temperature sensitive nerves in the gullet. The Clinical Physics Department at Barts and The London has pioneered the use of the Peltier device for use in the gullet, and now with the help of the new grant we can begin to test the device in human volunteers and eventually patients. It is hoped that this novel adaptation of technology will help us to understand the reason why some patients don't respond to standard treatment and may help us to improve our management strategies for these patients."

Notes

1. The miniature monitoring device is based on the "Peltier effect." This involves transfer of heat from one side of a device to the other against a hot and cold scale of the temperature of the oesophagus. This effect bears the name of Jean-Charles Peltier (a French physicist) who discovered it in 1834.

2. Currently, sensory testing is conducted using a range of techniques, for example the acid perfusion test, where a tube is inserted into a patient's oesophagus via their nose; mild hydrochloric acid is then sent down the tube, followed by salt water, in an attempt to reproduce symptoms of reflux.

3. The oesophagus is a tube of smooth muscle that transports food from the throat to the stomach.

4. Dr Reeves from The Royal London Hospital's Clinical Physics Clinical Academic Unit is working in collaboration with the Neurogastroenterology Group within the Department of Gastroenterology in Whitechapel, east London.

5. Nine other healthcare scientists from across England were also awarded research fellowships worth a total of over £1million for projects that will lead to improvements in patient care. The scheme is funded by the Department of Health (CSO) and managed by the National Institute for Health Research (NIHR).

Source
Barts and The London