Warrington and Halton Hospitals

Gastroenterology and liver studies

Dr Ramakrishnan is recruiting to various gastroenterology and Liver studies including;


Take part in the first major European prospective observational study on the benefits and risks of biologic therapies in IBD, patients who have never received biological agents or immunosuppressant (all 5-ASA and steroids formulations are permitted) patients receiving thiopurines alone patients treated with anti-TNF therapy alone without any concomitant immunosuppressant patients treated with anti-TNF therapy in combination with thiopurines or methotrexate patients: For investigators following IBD patients treated with vedolizumab.


The IBD BioResource aims to support studies looking at how genes and environmental factors influence disease and response to therapy. By gaining more  information on the genes involved in Crohn’s disease and ulcerative colitis and by understanding the differences in their function and integrating information regarding environmental influences including the microbiota we hope to gain insights regarding causal mechanisms, potential new therapies and treatment approaches for IBD to reduce the burden of disease, and begin to think about a cure.

Also, by working together with the NIHR BioResource, The IBD BioResource can benefit from being able to access a robust and tested system of re-call for volunteers to take part in medical research studies based on their genotype and/or phenotype.

Genetics of PBC study on

This is a UK-wide Project aimed at finding genetic factors involved in causing Primary Biliary Cholangitis (PBC, formerly known as Primary Biliary Cirrhosis). The UK-PBC Genetics Study is part of the National Institute for Health Research (NIHR) Rare Disease - Translational Research Collaboration (RD-TRC), which provides a world-class NHS research infrastructure to support fundamental discoveries in  rare diseases that may be used to improve patient care.


PSC Genetics Study

UK Collaborative Study to determine the Genetic Basis of Primary Sclerosing Cholangitis PSC.

At the present time the cause of PSC is as yet not known. However, it is believed that genetic factors may be important in the cause of this disease. We are currently collaborating in a UK wide study trying to find those genetic factors that cause PSC. If the study is successful, researchers may have a better chance of developing more effective treatments for this disease and understanding what causes PSC.

Patients taking part in this study will be asked to donate either blood sample or a saliva sample so researchers at Cambridge can extract the DNA from this sample and use it to potentially find the genes that cause PSC.


A study to find out why certain people develop oesophageal cancer.

This study is looking at whether your genes affect your risk of developing cancer of the food pipe (oesophageal cancer). You can take part if you have inflammation of the oesophagus (Oesophagitis) caused by long term acid indigestion (reflux), Barrett’s oesophagus or oesophageal cancer.

There are several risk factors for oesophageal cancer. These include things such as lifestyle, the environment or genetic makeup.

This study will collect blood samples from people who have reflux (also called erosive) oesophagitis, Barrett’s oesophagus or oesophageal cancer to study their DNA.

Researchers have already identified some genes that may affect the risk of oesophageal cancer, but they want to learn more.

In this study, the researchers will collect blood samples from people to help find out possible causes of oesophageal cancer that are related to their genes.

The aims of the study are to find out why:

  • Some people develop Barrett’s oesophagus
  • Some people with Barrett’s oesophagus then develop oesophageal cancer.

You won’t get any direct benefit from taking part in this trial, nor will it affect any treatment you have. But it will help researchers find out more about the genetic causes of oesophageal cancer.


Personalising Anti-TNF therapy in Crohn’s disease.

The anti-TNF drugs, Infliximab and Adalimumab, have greatly advanced the treatment of Crohn’s disease. However, some patients do not respond to treatment, and others lose response to he drugs with time. In addition patients occasionally experience unpredictable side effects which may be severe. The purpose of this study is to identify why some patients develop these problems, whilst other patients do not.

It is hoped that we might then be able to develop a test to predict which patients are likely to benefit, and least likely to suffer side effects. This information will allow these drugs to be used in a safer, more cost effective way, tailored to the individual patient.


Recent evidence suggests that side effects to some drugs may be determined by our genes (the basic building blocks of life). The purpose of this study is to identify the genes which determine the side effects caused by the drugs above. It is hoped that we might then be able to develop a test to predict which patients will develop these serious side effect before patients are treated. The PRED4 study involves giving consent, and supply a blood sample and a health professional in the hospital accessing your medical record to collect some medical history.

Predicting serious drug side effects include the following arms:

  • Anti- TNF induced demyelination in inflammatory disease
  • Thiopurine induced liver injury in IBD
  • Thiopurine induced leucopaenia in IBD
  • Thiopurine induced pancreatitis (TIP) in IBD
  • PPI induced nephritis
  • Sulfasalazine induced neutropenia in IBD and RA.

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