FIT test and the management of Acute Diverticulitis

  • Research type

    Research Study

  • Full title

    Can measurement of faecal haemoglobin concentration improve the management of acute diverticulitis?

  • IRAS ID

    274358

  • Contact name

    Craig Mowat

  • Contact email

    Craig.Mowat2@nhs.scot

  • Sponsor organisation

    University of Dundee

  • Duration of Study in the UK

    0 years, 7 months, 1 days

  • Research summary

    Diverticular disease is responsible for 12,000 hospital stays each year in Scotland; most commonly due to infection (acute diverticulitis) which is diagnosed by symptoms, examination, blood tests and a CT scan. The treatment is a course of antibiotics. Rarely, bowel cancer can mimic acute diverticulitis appearances on the CT scan. Currently all patients return for further investigation by colonoscopy around 7-12 weeks later once the antibiotics are complete. A colonoscopy is an invasive procedure, whereby a flexible tube is inserted into the lower bowel to examine the lining. However, studies have shown that only 2% of patients will have underlying cancer.
    Measurement of blood within the faeces with a FIT test is now common place to help predict which patients may have underlying bowel cancer; the patient takes a tiny sample of faeces and returns the test to the laboratory. FIT is used in the National Bowel Cancer Screening programme, and by GPs when they see a patient with new bowel symptoms. Patients with no blood in the faeces are very unlikely to have bowel cancer and can be reassured that colonoscopy is not necessary.
    Aim
    We wish to study whether a FIT test could improve the care of patients with acute diverticulitis and avoid colonoscopy.
    Methods
    We propose a short study (pilot study) to see whether it is feasible. Over a 6-month period, we will recruit 50 patients admitted to Ninewells Hospital with acute diverticulitis. Participants will take a FIT test in hospital and repeat the FIT at weekly intervals up to the date of their colonoscopy. FIT test results will be retained by research staff. We will study whether acute diverticulitis is associated with traces of blood in the faeces, the effect of antibiotics, and whether the amount of blood in the faeces predicts the findings at colonoscopy.

  • REC name

    West of Scotland REC 5

  • REC reference

    20/WS/0147

  • Date of REC Opinion

    23 Oct 2020

  • REC opinion

    Favourable Opinion