Inflammatory Bowel Disease (IBD)

The the Inflammatory Bowel Diseases Service at the Royal Liverpool is extensive and in the recent IBD national Audit came out as one of the top units in the UK

IBD Team

The IBD team at the Royal Liverpool University Hospital includes 7 Consultants, one specialist
nurse, two research nurses and four middle grades doctors (Specialist Registrars) (see table 1 below).  The IBD team is well supported by three Radiologists who have a special interest in bowel imaging.

Table 1: The IBD Team

Out-patient services

The outpatient services are shown in table 2 below. We are in the process of reorganising our existing clinics in to two large joint clinics predominantly dedicated to the care of patients with IBD. There are many advantages to a joint clinic such as access to a dietitian, specialist nurse and a higher likelihood of being assessed by a Consultant with a special interest in IBD. The joint ‘IBD clinics’ will consist of 3 or 4 Medical Consultants, a Specialist Nurse, a research Nurse and two SpRs.  We also have access to a specialist dietitian in the clinic to provide support to patients where necessary. We accept referrals from primary, secondary and tertiary care.  There are also two nurse led clinics, which include clinics for monitoring of bloods for immunosuppressant treatment and for those with stable IBD.  In addition, the IBD specialist nurse provides telephonic support for patients who need urgent advice.

Table 2:

Clinical Research

The department has a long standing interest in clinical trial, particularly in new therapies for inflammatory bowel disease.

We are involved in several clinical trials of new therapies for IBD at present. Some of these are local trials whilst others are multi-centre multinational trials. We have a dedicated, experienced  research nurse, Kate Martin, who is involved in co-ordinating trials and reviewing trial patients. We have also recently appointed an additional research nurse, Andrew Kneebone. Some of the current clinical trials include:

Triple antibiotics vs budesonide in active Crohn’s disease - A local trial for people with active Crohn’s disease. The aim of the trial is to work out how a 3 antibiotic treatment compares with standard steroid treatment. Participants will be randomly assigned either A) 3 antibiotics (ciprofloxacin,trimethoprim and metronidazole for 10 weeks or B) budesonide  (a standard steroid therapy for Crohn’s disease) for 12 weeks.

Plantain to prevent relapse of Crohn’s disease - A trial for people with current inactive Crohn’s disease (but flared up at sometime in the previous year). The aim is to evaluate whether plantain fibre reduces the flare up rate in Crohn’s disease. Participants are randomly assigned to plantain fibre (banana fibre) or placebo for one year.

Laquinomod in active Crohn’s disease - Part of a multicentre study for patients with active Crohn’s disease to evaluate whether a new drug laquinomod reduces the activity of Crohn’s disease.

TOPPIC trial - A multi-centre trial to examine whether mercaptopurine (an immunosuppressive drug) reduces the recurrence of Crohn’s disease after sugery. Participant are randomised to mercaptopurine or placebo and are assessed by endoscopy and by symptoms recurrence.

Adalimumab registry - A long-term safety follow up trial of people with Crohn’s disease who are receiving adalimumab.

CONSTRUCT - A nationwide trial to examine which of two immunosuppressive drugs (ciclosporin or infliximab) is better in treating people with very active ulcerative colitis.

Cycol - A multicentre trial to examine the efficacy of a novel formulation of ciclosporin for the management of ulcerative colitis.

There are several further trials in development. You could discuss your suitability for participation in trials during your clinic appointment or contact one of the research nurses.

• Patient Services
• Out-patient Services
• Endoscopy
• Liver
• Inflammatory Bowel Disease (IBD)
• Upper GI Services
• Nutritional Services
• Bowel Cancer Screening
• Colorectal Services