Gastrointestinal Hypomotility Study: Studying how Intestinal Transit is affected by Clozapine

Gastrointestinal hypomotility ("slow gut") caused by clozapine is common, important and poorly understood. It causes distress and even sudden death. It may affect more than half of clozapine treated patients, but there are no clinically reliable signs and symptoms to identify it. One in 500 clozapine treated patients die from drug­induced bowel obstruction. Segmental gastrointestinal transit times (e.g. gastric and small bowel emptying) of clozapine treated patients have never been quantified. This is an extension of a previous study which used radiopaque markers to explore gastrointestinal transit time in clozapine treated patients. These results showed very abnormal bowel function, but data were crude and limited to the colon. This study involves similar methodology, but a more sensitive measurement technique ­-a wireless motility capsule­ -which will provide more data and add to the understanding of this problem. Wireless motility capsules ('smartpills') are vitamin-­pill sized capsules. When swallowed they offer an ambulatory, safe, minimally invasive and validated assessment of intraluminal pH, temperature, and pressure during their transit through the gastrointestinal (GI) tract. There is no radiation exposure to the patient. This technology allows for accurate measurement of transit times in multiple regions of the upper and lower GI tract. benefit them individually, as well as informing the evidence base.