Robin Spiller

Robin Spiller
University of Nottingham | Notts · Nottingham Digestive Diseases Centre

MB BChir MSc MD Cantab FRCP

About

555
Publications
58,713
Reads
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32,077
Citations
Citations since 2016
88 Research Items
13817 Citations
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Introduction
Additional affiliations
January 2009 - present
University of Nottingham
Position
  • Lead Director
January 2000 - present
Nottingham University Hospitals NHS Trust
Position
  • Head of Department
Description
  • Professor of Gastroenterology Focus of reserach on functional GI diseases Imaging gut function using MRI Clinical trials in IBS

Publications

Publications (555)
Article
Full-text available
Objective The gastrointestinal environment in which drug products need to disintegrate before the drug can dissolve and be absorbed has not been studied in detail due to limitations, especially invasiveness of existing techniques. Minimal in vivo data is available on undisturbed gastrointestinal motility to improve relevance of predictive dissoluti...
Article
Full-text available
Objective: In England, 27,500 children are referred annually to hospital with constipation. An objective measure of whole gut transit time (WGTT) could aid management. The current standard WGTT assessment, the x-ray radiopaque marker (ROM) test, gives poor definition of colonic anatomy and the radiation dose required is undesirable in children. Ou...
Article
Background: Whole apples produce greater satiety than processed apples, but the underlying mechanisms remain unclear. Objective: Our aim was to assess the intragastric processing of apple preparations and the associated small and large bowel contents using MRI. Methods: An open label, 3-way crossover, randomized, controlled trial. Eighteen hea...
Article
Background Cystic fibrosis (CF) is a multi-system genetic disorder affecting >72,000 people worldwide. Most CF patients experience gastrointestinal symptoms and can develop complications. However, the mechanisms of CF gut disease are not well understood. We evaluated gut function and transit in CF using magnetic resonance imaging (MRI). We hypothes...
Article
Full-text available
Measurement of gastric emptying is of clinical value for a range of conditions. Gamma scintigraphy (GS) has an established role, but the use of magnetic resonance imaging (MRI) has recently increased. Previous comparison studies between MRI and GS showed good correlation, but were performed on separate study days. In this study, the modalities were...
Article
Full-text available
Background: Crohn's disease (CD) patients suffer postprandial aversive symptoms, which can lead to anorexia and malnutrition. Changes in the regulation of gut hormones and gut dysmotility are believed to play a role. Objectives: This study aimed to investigate small-bowel motility and gut peptide responses to a standard test meal in CD by using...
Article
Whole grain cereal breakfast consumption has been associated with beneficial effects on glucose and insulin metabolism as well as satiety. Pearl millet is a popular ancient grain variety that can be grown in hot, dry regions. However, little is known about its health effects. This study investigated the effect of a pearl millet porridge (PMP) compa...
Article
Full-text available
Background Complications of diverticular disease are increasingly common, possibly linked to increasing obesity. Visceral fat could contribute to the development of symptomatic diverticular disease through its pro-inflammatory effects. Objective The study had 2 aims. A) to develop a semi-automated algorithm to measure abdominal adipose tissue from...
Article
Colonic diverticula are formed by mucosal outpouching from the colonic wall. Their presence increases with increasing age with most, in Caucasian, being situated in the left colon. The aetiology of these outpouchings is not fully understood but dietary, lifestyle and genetic factors have all been implicated. Most patients with diverticula are asymp...
Article
Magnetic resonance imaging (MRI) is a well established technique that has revolutionized diagnostic radiology. Until recently, the impact that MRI has had in the assessment of gastrointestinal motor function and bowel fluid distribution in health and in disease has been more limited, despite the novel insights that MRI can provide along the entire...
Article
Full-text available
Glycaemic, gastrointestinal, hormonal and appetite responses to pearl millet and oats porridge breakfast: a randomized, crossover trial - Volume 77 Issue OCE4 - Jaber Alyami, Ella Whitehouse, Susan E. Pritchard, Caroline L. Hoad, Khaled Heissam, Elaine Blackshaw, Sally Cordon, Robin C. Spiller, Penny A. Gowland, Ian A. Macdonald, Guruprasad P. Aith...
Article
Full-text available
Background: Clostridium difficile infection (CDI) recurs after initial treatment in approximately one in four patients. A single-centre pilot study suggested that this could be reduced using 'follow-on' rifaximin treatment. We aimed to assess the efficacy of rifaximin treatment in preventing recurrence. Methods: A multisite, parallel group, rand...
Article
Full-text available
Background & aims Ingestion of poorly digested, fermentable carbohydrates (fermentable oligo-, di-, mono-saccharides and polyols; FODMAPs) have been implicated in exacerbating intestinal symptoms and the reduction of intake with symptom alleviation. Restricting FODMAP intake is believed to relieve colonic distension by reducing colonic fermentation...
Data
Details of food package contents. Food package contents provided to study subjects 24 hours prior to MRI scan for baseline (standard food package) and post-intervention (low FODMAP food package). (PDF)
Data
Variation in microbial taxa with gas groupings. Data is either shown as relative abundance (% total) for bacteria or amount of the Methanobrevibacter specific nifH-gene per μg template DNA. Gas groupings were defined according to cut-off values; >20 ppm hydrogen and <20 ppm methane (Hydrogen), >20 ppm methane and <20 ppm hydrogen (Methane), >20 ppm...
Data
Associations between colonic volume and other variables. Data for both time points is shown with linear model fits as lines and shaded areas representing 95% confidence intervals. A) Colonic volume correlates with transit (WAPS) at baseline (r = 0.43, p<0.01), post-intervention (r = 0.37, p<0.05) and overall (r = 0.43, p<0.01). B) Colonic volume co...
Data
Detailed dietary breakdown. Table of mean daily intake for individual dietary components. The intervention supplements are not included. MD, maltodextrin; OF, oligofructose; BL, baseline; PI, post-intervention. SD values given in brackets. Values which differ significantly from baseline are shown in bold. (PDF)
Data
Variation in urinary metabolite profiles between groups. Principal Coordinates Analysis of urinary metabolite profiles showing separation between baseline and post-intervention samples. BL = baseline, MD = maltodextrin, OF = oligofructose. (TIF)
Data
Supplementary methods. Detailed description of methods for dietary and metabolomics analysis. (PDF)
Data
Detailed study protocol. (PDF)
Data
Detailed microbiota changes. Complete list of significant genus level changes post-intervention compared to the baseline. FDR corrected p-values >0.05 are show in bold. (PDF)
Data
Faecal short chain fatty acid concentrations. Short chain fatty acid concentrations per study group. MD, maltodextrin; OF, oligofructose; BL, baseline; PI, post-intervention. No significant differences between the groups. Values shown are mean (SD) μmol/g wet stool per group. (PDF)
Data
R script for microbiota testing. R script for comparing the microbiota to categorical and continuous variables using the package Microbiota Analysis in R Easily (mare). Viewable with any text editor. (R)
Data
Associations between the microbiota and short chain fatty acids. Statistically significant associations between genus level taxa and short chain fatty acids, across both time points, showing positive or negative associations calculated with linear mixed models. (PDF)
Data
Full output of microbiota comparison by study group. Tabulated output from the GroupTest function within mare indicating relative abundance, fold change, raw and corrected p-values for all identified genera by study group. (XLSX)
Article
Background In functional gastrointestinal disorders a lack of objective biomarkers limits evaluation of underlying mechanisms. We aimed to demonstrate the utility of magnetic resonance imaging for this task using psyllium, an effective constipation treatment, in patients and controls. Methods Two crossover studies: (i) adults without constipation...
Article
Background: Gastrointestinal infection is an important risk factor for developing irritable bowel syndrome (IBS). Our aim was to characterise post-infectious IBS (PI-IBS) compared to other IBS patients. Methods: An internet survey of IBS patients using Rome III diagnostic questionnaire, Hospital Anxiety and Depression Scale (HADS) and Patient He...
Article
Background Plant foods may stimulate intestinal secretion through chemicals designed to deter herbivores, including lactucins in lettuce and rhein in rhubarb. This may increase ileostomy output and induce diarrhoea in people with intact bowels. Objective We aimed to determine the effect of food on intestinal water content using Magnetic Resonance...
Article
Full-text available
Background Magnetic Resonance Imaging (MRI) of small-bowel motility in Crohn’s disease (CD) is a sensitive disease activity biomarker and linked to patient symptoms1. Intestinal inflammation is associated with an increase in Polypeptide YY (PYY), Glucagon-like peptide 1 (GLP-1) and cholecystokinin (CCK)2. These peptides have a negative effect on in...
Article
Background: Recent studies have shown that the brain of patients with gastrointestinal disease differ both structurally and functionally from that of controls. Highly somatizing diverticular disease (HSDD) patients were also shown to differ from low somatizing (LSDD) patients functionally. This study aimed to investigate how they differed structur...
Article
Cereal grain based porridges are commonly consumed throughout the world. Whilst some data are available for varieties that are popular in the Western world such as oats and rye, other ‘ancient’ grains used in the East and in Africa such as millets are thought to have beneficial health effects, such as a suppression of post prandial hunger and circu...
Article
Functional bowel disorders affect a significant proportion of people word wide. Patients suffer from longstanding symptoms of abdominal pain or discomfort in combination with abnormal bowel habits. The evidence for role of microbiota is currently contradictory and descriptive. This review aims to summarize the reasons which include methodological d...
Article
Background: Feeding triggers inter-related gastrointestinal (GI) motor, peptide and appetite responses. These are rarely studied together due to methodological limitations. Recent MRI advances allow pan-intestinal, non-invasive assessment of motility in the undisturbed gut. This study aimed to develop a methodology to assess pan-intestinal motilit...
Article
The American Journal of Gastroenterology is published by Springer Nature on behalf of the American College of Gastroenterology (ACG). Ranked the #1 clinical journal covering gastroenterology and hepatology*, The American Journal of Gastroenterology (AJG) provides practical and professional support for clinicians dealing with the gastroenterological...
Conference Paper
Introduction Clostridium difficile associated diarrhoea (CDAD) is a common nosocomial infection that recurs in more than 1 in 4 cases. Garey et al. found that a course of rifaximin after standard therapy reduced relapse rate though not significantly¹. We aimed to confirm or refute this finding. Design A parallel group, randomised, placebo controll...
Article
The rate and extent of drug dissolution and absorption from solid oral dosage forms is highly dependent on the volume of liquid in the gastrointestinal tract (GIT). However, little is known about the time course of GIT liquid volumes after drinking a glass of water (8 oz), particularly in the colon, which is a targeted site for both locally and sys...
Article
Full-text available
Background: Previous studies have reached conflicting conclusions regarding the efficacy of mesalazine in the prevention of recurrent diverticulitis. Aim: To investigate the efficacy and safety of mesalazine granules in the prevention of recurrence of diverticulitis after acute uncomplicated diverticulitis. Methods: Two phase 3, randomised, pl...
Article
Background: We have previously reported a non-invasive, semi-automated technique to assess motility of the wall of the ascending colon (AC) using Magnetic Resonance Imaging. This study investigated the feasibility of using a tagged MRI technique to visualize and assess the degree of flow within the human ascending colon in healthy subjects and tho...
Article
Many patients report symptoms come on after eating, and experience with exclusion diets suggests that certainly poorly absorbed but rapidly fermentable carbohydrates may be responsible. While monomeric and short chain carbohydrate polymers exert osmotic forces and trap water in the small bowel with acceleration of transit, the longer polymer polyme...
Article
As individuals living a Western lifestyle age, the prevalence of diverticulosis steadily rises reaching around 50% over the age of 75 years.1 While for most this is a harmless ageing change reflecting weakening of colonic connective tissue, around 30% suffer recurrent abdominal pain, often with diarrhoea,2 and 1–4% will be hospitalised with diverti...
Article
Full-text available
Objectives: Non-invasive biomarkers which identify different mechanisms of disease in subgroups of irritable bowel syndrome (IBS) could be valuable. Our aim was to seek useful magnetic resonance imaging (MRI) parameters that could distinguish each IBS subtypes. Methods: 34 healthy volunteers (HV), 30 IBS with diarrhea (IBS-D), 16 IBS with consti...
Article
Although over half of patients over 65 years old will have diverticulosis, only a minority experience symptoms. These are often similar to those of irritable bowel syndrome with pain and disordered bowel habit, but differ in having an onset in the sixth to seventh decade. The underlying mechanisms include visceral hypersensitivity which maybe posti...
Article
Background & aims: Poorly digested, fermentable carbohydrates may induce symptoms of irritable bowel syndrome (IBS), via unclear mechanisms. We performed a randomized trial with magnetic resonance imaging (MRI) analysis to investigate correlations between symptoms and changes in small and large bowel contents following oral challenge. Methods: W...
Conference Paper
Although over half of patients over 65 years old will have diverticulosis, only a minority experience symptoms. These are often similar to those of irritable bowel syndrome with pain and disordered bowel habit, but differ in having an onset in the sixth to seventh decade. The underlying mechanisms include visceral hypersensitivity which maybe posti...
Article
The acute phase of IBD with inflamed gut and often ulcerated mucosa is clearly different from the apparently normal mucosa characteristic of IBS. However, more detailed assessment has detected immune activation, increased gut permeability, increased mucosal serotonin availability, abnormalities of enteric nerve structure and function, and dysbiosis...
Article
Full-text available
Background: The consumption of fat is regulated by reward and homeostatic pathways, but no studies to our knowledge have examined the role of high-fat meal (HFM) intake on subsequent brain activation to oral stimuli. Objective: We evaluated how prior consumption of an HFM or water load (WL) modulates reward, homeostatic, and taste brain responses t...
Article
Clostridium difficile ( Peptoclostridium difficile ) is a common health care associated infection with a disproportionately high incidence in elderly patients. Disease symptoms range from mild diarrhoea through to life threatening pseudomembranous colitis. Around 20% of patients may suffer recurrent disease which often requires re-hospitalisation o...
Data
Table S1 Intergroup analysis. Table S2 Covariate analysis.