Dr. Satish S.C. Rao, Professor of Medicine and Director of Neurogastroenterology and GI Motility at the University of Iowa Carver College of Medicine, has been named Chief of the Section of Gastroenterology and Hepatology and founding Director of the Digestive Health Center at Augusta University.

Rao, President of the American Neurogastroenterology and Motility Society, will lead an aggressive initiative to expand the university’s capabilities in treating digestive disorders which affect 1 in 4 Americans, said Dr. Michael Madaio, Chairman of the GHSU Department of Medicine. He joins the faculty Sept. 1.

“The area of digestive disorders is of great importance to the patient population we serve and we need to serve them better by growing resources, particularly for those with complex problems,” Madaio said. “We also want to enhance patient referral support to physicians in our community and state.”

Rao’s success at helping build a multidisciplinary digestive health center in Iowa combined with his acumen at integrating a busy clinical practice and clinical research make him a logical choice to lead this initiative, Madaio said. He plans to work closely with colleagues in surgery, urology, otolaryngology and neurology to create a model system that serves patients and referring physicians as it advances the understanding, treatment and prevention of digestive disease.

His expertise includes non-cardiac chest pain; paralysis of the stomach (gastroparesis), which reduces the stomach’s ability to empty its contents; irritable bowel syndrome; fecal incontinence; constipation; gas and bloating; as well as problems resulting from poor communication between the brain and gut. Rao discovered one such disconnect, called dyssynergic defecation, which causes constipation in one-third of Americans by impairing muscle control. He also pioneered the biofeedback therapy that effectively treats 80 percent of these patients.

Rao’s research has been continuously funded by the National Institutes of Health for more than 15 years. He received the three highest honors from American Gastroenterological Association: the Distinguished Clinician Award in 2003, the Masters Award for Outstanding Clinical Research in 2006 and the Distinguished Educator Award in 2007. Rao also received the International Foundation for Functional Gastrointestinal Disorders 2009 Senior Investigator-Clinical Science Award as well as the American College of Gastroenterology’s highest research award, the Auxillary Research Award in 2005. He chaired the American Motility Society’s Clinical Practice Session from 2004-10 and was the American College of Gastroenterology’s Governor from Iowa in 2009. He serves on the editorial board of Annals of Gastroenterology & Hepatology.
Rao, an accomplished educator and mentor, has been included among Castle Connolly Medical, Ltd.’s America’s Top Doctors and Best Doctors in America since 2001 and the Consumers’ Research Council of America’s Top Physicians since 2003.

He is a graduate of Osmania Medical College at Osmania University in Hyderabad, India, and completed graduate medical education and fellowship training at several United Kingdom hospitals before being named a Fellow of the Royal College of Physicians in London. He earned a Ph.D. from the University of Sheffield in the U.K. in GI motility and completed a fellowship in advanced gastrointestinal endoscopy and therapeutics at the U.K.’s Royal Liverpool Hospital.

Georgia Health Sciences University

Founded in 1828, Georgia Health Sciences University is home to the Medical College of Georgia, the 13th-oldest continuously operating medical school in the United States and the third-oldest in the Southeast.

GHSU has more than 2,400 students in five colleges: the Medical College, Allied Health Sciences, Dental Medicine, Graduate Studies and Nursing. Students come from most of Georgia’s 159 counties.

GHSU offers modern classrooms and laboratories, the 478-bed MCGHealth Medical Center, the Children’s Medical Center, extensive outpatient clinics, residence halls, a student center, a wellness center and an outstanding medical education library.

With approximately 5,000 faculty, staff and residents (9,000 enterprise-wide), GHSU is one of the largest employers in the Augusta area. The University System of Georgia reports that during the 2007 fiscal year, an additional 3,800 jobs resulted from spending related to the institution, and its overall economic impact on the area approached nearly $1 billion.

 Randomized Controlled Trial of Treating Rectal Hypersensitivity - Comparing Escitalopram With Sensory Adaptation Training

Constipation is a common digestive disorder. After excluding dietary factors, drugs and other secondary causes, at least three broad pathophysiologic subtypes are recognized- dyssynergic defecation, constipation-predominant irritable bowel syndrome (IBS-C) and slow transit constipation (STC), all predominantly affect women and elderly. Many patients also demonstrate abnormal rectal perception with both rectal hyposensitivity and hypersensitivity being common. Recent surveys show that most constipated patients are dissatisfied with current therapy. Also, constipated patients showed significant psychological dysfunction and impaired quality of life.

Estimated Enrollment: 60
Study Start Date: December 2007
Estimated Study Completion Date: December 2007
Estimated Primary Completion Date: February 2012 (Final data collection date for primary outcome measure)

Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: No

 Investigation of Dietary Absorptive Capacity of Fructans in Healthy Subjects - A Dose Response Study

Fructan is a carbohydrate polymer that is composed of fructose and a terminal glucose moiety . Fructans are naturally found in artichokes (6.1 grams/serving), leeks (5.9 grams/serving), onion bulbs (1.01 grams/serving), flour (4.0 grams/serving), garlic (.52 grams/serving), watermelon (.92 grams/serving), nectarines (.27 grams/serving) and white peaches (.50 grams/serving). Because fructans are present in many common foods, people typically ingest high levels of fructan. The most common structural forms of fructan are inulin, levanare and geraminan . The human body absorbs only 5% of fructan, however it is estimated that the daily intake in the USA may vary between 1-20 grams, and possibly higher due to the recently discovered benefits of inulins . Dietary trends indicate that high levels of fructans are common in the European and American diet, as more wheat based products such as breakfast cereal, pasta, and bread are consumed.

Fructans may not be well tolerated by some subjects and its malabsorption may result in gastrointestinal (GI) symptoms such as heartburn, belching, abdominal pain, diarrhea, gas, and bloating; and this is especially true when higher doses are ingested. Unlike glucose, fructans are not efficiently digested or absorbed by the small intestine. The mechanism for malabsorption is related to the inability to hydrolyze glycosidic linkages in the complex polysaccharide, resulting in the delivery of malabsorbed fructans to the large bowel1. In the colon, the malabsorbed fructans are rapidly fermented, and byproducts of this fermentation include H2, CH4, and other gases that may contribute to bowel symptoms. Furthermore, the small molecular nature of fructans results in an osmotic effect which draws more water into the small intestine and causes bloating and diarrhea.

Ingestion of high doses of fructans can cause symptoms in healthy adults, but may cause more bothersome symptoms in subjects with Irritable Bowel Syndrome (IBS). Earlier studies have identified that IBS affects between 10 and 15% of the population in the United States. Ingestion of 10-20 grams of fructan daily may cause symptoms of IBS, and restricting fructan intake in a diet may reduce symptoms in a variety of gastrointestinal disorders. One study recently published found that dietary restriction of fructan and fructose was responsible for symptomatic improvement in patients with IBS.

Estimated Enrollment: 19
Study Start Date: June 2009
Estimated Study Completion Date: December 2010
Estimated Primary Completion Date: March 2010 (Final data collection date for primary outcome measure)

Ages Eligible for Study: 18 Years and older
Genders Eligible for Study: Both
Accepts Healthy Volunteers: Yes

 Clinical Management With SPM System and Validation of the SPM 5 Hour Cutoff in Patients With Symptoms of Gastroparesis

This protocol is designed to validate use of the SPM for diagnosis of delayed gastric emptying in patients with symptoms of gastroparesis and assess impact of a SmartPill study on patient management in the gastroparetic populations. Patients with symptoms of gastroparesis will be recruited.

Patients will undergo concurrent gastric scintigraphy and SPM testing to determine the presence or absence of delayed gastric emptying based on predetermined diagnostic cutoffs for each technique.

Estimated Enrollment: 250
Study Start Date: January 2014
Estimated Study Completion Date: July 2016
Estimated Primary Completion Date: January 2016 (Final data collection date for primary outcome measure)

 Investigation of Linaclotide's Effect on the Bi-directional Brain and Gut Axis in IBS-C Patients

The purpose of this study is to understand how a drug called Linaclotide improves bowel function and abdominal pain in patients with Irritable Bowel Syndrome with Constipation (IBS-C) as well as to examine whether Linaclotide alters communication between the brain and pelvic-floor region.

Linaclotide has been shown to improve abdominal pain and bowel symptoms in IBS-C, and is approved by the FDA for the treatment of this condition. However, how exactly this drug works to relieve abdominal pain and discomfort in humans is not clearly known. Studies in animal models suggest that patients with IBS-C have hypersensitivity in the gut.

Consequently, in IBS-C patients, there is rapid and excessive conduction of signals both from the brain and central nervous system region towards the pelvic-floor (anorectal axis) and the reverse direction. The investigators hypothesize that treatment with Linaclotide may improve/normalize these signals and thereby improve bowel symptoms.

Investigators will test this theory using a new, noninvasive (and established) method of studying this communication pathway between the brain and gut.

Estimated Enrollment: 45
Study Start Date: February 2014
Estimated Primary Completion Date: February 2016 (Final data collection date for primary outcome measure)