- Key Publications
Our research focuses on the role of the gut microbiome and diet in inflammatory bowel disease (IBD) and other gut disorders with the overarching aim of improving patient outcomes and quality of life. We are investigating interventional approaches to manipulate the gut microbiome for therapeutic effect, in particular using dietary therapies and faecal microbiota transplantation; alongside clinical research in the area of IBD and gastrointestinal ultrasound.
Our research group strives to incorporate high quality clinical studies coupled with novel basic science methodology in a collaborative framework, to yield translational therapeutic advancement for IBD. Insights from our research aim to shed light on IBD pathogenesis and thereby progress the field toward cure.
What is IBD?
Inflammatory bowel diseases (IBD) are chronic inflammatory conditions, which are relapsing and remitting in nature, without medical cure. The incidence of prevalence of IBD is dramatically rising globally, and Australia has one of the highest rates in the world. IBD is associated with high rates of surgery and hospitalisation, with a concordant loss of quality of life (QoL) and disability. Despite an expanding therapeutic armamentarium, current treatments targeting the immune system remain inadequate with an efficacy of <40%.
Microbial manipulation in IBD
Microbial manipulation represents a new treatment paradigm that has the potential to bridge the therapeutic gap in IBD. Whilst most research to date has focused on immunological mechanisms, inflammation in IBD may be the sequelae of interactions occurring between the gut microbiota and epithelial cells lining the digestive tract. Epidemiological trends in IBD closely correlate with widespread loss of gut microbial diversity, attributable to changes in dietary intake and broad adoption of a Western diet. Gut microbial dysbiosis and changes in fermentation are consistently observed in patients with IBD. Microbial manipulation in IBD is a therapeutic option for patients that is non-immunosuppressive, harnessing an alternative mechanism of action to conventional IBD therapies.
Pioneering novel microbial and diet therapies
Emerging data suggests that microbial manipulation, using faecal microbiota transplantation (FMT) and prescribed dietary strategies, holds promise for effective management of IBD.
FMT is defined as the transfer of faecal material from a healthy donor to a person with an illness with the aim of treating disease. We have demonstrated that FMT can safely induce remission of active ulcerative colitis. Our group is actively studying the role of FMT to maintain remission of ulcerative colitis as well as its ability to treat Crohn’s disease. We are also exploring the role of FMT in a broader range of indications, including in neurodegenerative disorders and in the oncological setting.
Our research group has also published a pilot dietary intervention study, testing a novel dietary strategy which has the potential to influence management paradigms for patients with ulcerative colitis. The diet was well-tolerated and improved inflammation and symptoms in participants. This study has informed the rationale and methodology for a high-impact randomised controlled trial exploring the efficacy of this diet in patients with ulcerative colitis, which is currently underway at BHI/TQEH. The current trial has attracted competitive grant funding from multiple sources, including The Hospital Research Foundation, European Crohn’s and Colitis Organisation, and the Gutsy Foundation. The outcome of this trial is expected not only to influence clinical practice but to shed light on the pathogenesis of ulcerative colitis, through deep exploration of the functional microbial impacts of diet in inflammatory bowel disease.
Improving patient outcomes with IBD
Our group is dedicated to research which lead to tangible improvements in outcomes and quality of life for patients with IBD. Intestinal ultrasound (IUS) is a novel non-invasive tool for monitoring disease activity in IBD, which can be performed at the point-of-care. IUS can expedite clinical decision-making and appropriately direct therapy in IBD, in many instances avoiding expensive and invasive tests such as colonoscopy. IUS also allows real-time assess of bowel contents, which can allow directed management of non-inflammatory causes of gut symptoms, including constipation. Our group is leader for both training and research in IUS in Australia.
- 21 November 2022: Poo bank founders win first global approval for microbiome drug
- 17 November 2022: Prestigious Michell-McGrath Fellowship Awarded to Associate Professor Rob Bryant
- 17 October 2022: Super poo – how can faecal transplants and diet treat bowel disease?
- 2022: BiomeBank, an Adelaide Australia-first, gets lab to take healthy poo interstate and globally to treat gut conditions
- 22 October 2021: Diet tests pain in a gut (refer to Advertiser article below)
- 7 April 2020: Australian Prescriber Podcast (Episode 74): Faecal transplants
- 16 January 2019: The Advertiser article (subscriber content only): Faecal transplants can treat bowel disease ulcerative colitis (research article in JAMA)
- 20 May 2018: The Advertiser article (subscriber content only): Fecal transplant can stop deadly C.Diff infection – if you can stomach it
- 21 March 2018: THRF website: Getting to the bottom of gut health
|Alice Day||PhD, The University of Adelaide||2021||Exploring a patient-centered, diet-focused treatment paradigm for Inflammatory Bowel Disease||Andrews J, Bryant R|
|Rachel Davis||First Class Honours, Flinders University of South Australia||2019||Diet and inflammatory bowel disease||Day A, Bryant R, Miller M|
|Sam Costello||PhD, The University of Adelaide||2019||The role of faecal transplantation in the treatment of ulcerative colitis||Roberts-Thomson I, Hughes P, Conlon M, Andrews J|
Project: Examining a Sulphide-Reducing Diet as Therapy in Ulcerative Colitis: A Randomised, Single-Blind, Placebo-Controlled Dietary Advice Trial (EAT-UC RCT)
Principle investigators: Dr Alice Day & Associate Professor Rob Bryant
Associate investigators & collaborators: Dr Sam Costello, Prof Peter Gibson, Dr Sam Forster, Dr CK Yao, Prof Chris Probert, Malcolm Hebblewhite
Project: Faecal microbiota transplantation for maintenance of remission of Crohn’s disease
Principle investigator: Dr Karmen Telfer, MBBS, studying for MPhil
Supervisors: Prof Philip Weinstein, University of Adelaide, Dr Sam Costello
Project: Faecal microbiota transplantation for refractory ulcerative proctitis.
Principle investigator: Dr Sreecanth Raja, MBBS, studying for MPhil
Supervisors: Professor Christopher Rayner, University of Adelaide, A/Prof Robert Bryant, Dr Sam Costello
Project: Exclusive enteral nutrition in Inflammatory Bowel Disease
Principle investigator: Dr Matthew Chu, MBBS, studying for MPhil
Supervisors: A/Prof Robert Bryant, Dr Alice Day
Project: Helicobacter pylori resistance patterns in Australia
Principle investigator: Dr Jonathon Schubert, MBBS, studying for PhD
Supervisors: Professor Christopher Rayner, University of Adelaide, A/Prof Robert Bryant, Prof Ian Roberts-Thompson
Project: Intestinal ultrasound in Crohn’s disease
Dr Thomas Goodsall, MBBS, studying for PhD
Supervisors: Prof Jane Andrews, University of Adelaide, A/Prof Robert Bryant, A/Prof Chris Ma, University of Calgary
Project: Dietitian First clinic in Functional Gastrointestinal Disorders
Principle investigator: Samantha Plush, APD, studying for PhD
Supervisors: A/Prof Robert Bryant, Dr Alice Day, Professor Saravana Kumar, University South Australia
Project: Intestinal ultrasound to identify gastrointestinal contents
Principle investigator: Dr Ryan Mathias, MBBS, studying for PhD
Supervisors: A/Prof Robert Bryant, Dr Sam Costello, Dr Alice Day
Project: A dedicated Inflammatory Bowel Disease diet clinic (IBDDC): evaluating patient outcome measures, new modes of service delivery, and cost utility.
Principle investigator: Dr Alice Day
Associate investigators & collaborators: A/Prof Rob Bryant, Sangwoo Han, Dr Jyoti Khadka University of South Australia, Dr Matthew Chu
Please refer to the financial year Publication Lists for an annual updated list or researcher profiles for a full list of publications.
Costello, S., Hughes, P., Waters, O., Bryant, R., Vincent, A., Blatchford, P., . . . Andrews, J. (2019). Effect of fecal microbiota transplantation on 8-week remission in patients with ulcerative colitis: a randomized clinical trial. JAMA – Journal of the American Medical Association, 321(2), 156-164.
Raja, S. S., Bryant, R. V., Costello, S. P., Barnett, M., Schubert, J., & Rayner, C. K. (2023). Systematic review of therapies for refractory ulcerative proctitis. Journal of Gastroenterology and Hepatology (Australia), 38(4), 14 pages.
Tucker, E. C., Haylock-Jacobs, S., Rapaic, M., Dann, L. M., Bryant, R. V., & Costello, S. P. (2023). Stool donor screening within a Therapeutic Goods Administration compliant donor screening program for fecal microbiota transplantation. JGH Open, 7(3), 172-177.
Bogatic, D, Bryant, RV, Lynch, KD, Costello, SP. Systematic review: microbial manipulation as therapy for primary sclerosing cholangitis. Aliment Pharmacol Ther. 2023; 57: 23– 36. https://doi.org/10.1111/apt.17251
Bryant, R. V., Day, A. S., McGrath, K. C., Telfer, K., Yao, C. K., & Costello, S. P. (2021). Fecal microbiota transplantation augmented by a sulfide-reducing diet for refractory ulcerative colitis: A case report with functional metagenomic analysis. JGH Open, 5(9), 1099-1102.
Costello, S. P., Day, A., Yao, C. K., & Bryant, R. V. (2020). Faecal microbiota transplantation (FMT) with dietary therapy for acute severe ulcerative colitis.. BMJ Case Rep, 13(8), e233135.
Soo, W. T., Bryant, R. V., & Costello, S. P. (2020). Faecal microbiota transplantation: Indications, evidence and safety. Australian Prescriber, 43(2), 36-38.
Diet & IBD
Day, A. S., Yao, C. K., Costello, S. P., Ruszkiewicz, A., Andrews, J. M., Gibson, P. R., & Bryant, R. V. (2022). Therapeutic Potential of the 4 Strategies to SUlfide-REduction (4-SURE) Diet in Adults with Mild to Moderately Active Ulcerative Colitis: An Open-Label Feasibility Study. Journal of Nutrition, 152(7), 1690-1701.
Day, A. S., Yao, C. K., Costello, S. P., Andrews, J. M., & Bryant, R. V. (2022). Food-related quality of life in adults with inflammatory bowel disease is associated with restrictive eating behaviour, disease activity and surgery: A prospective multicentre observational study. Journal of Human Nutrition and Dietetics, 35(1), 234-244.
Davis, R., Day, A., Barrett, J., Vanlint, A., Andrews, J. M., Costello, S. P., & Bryant, R. V. (2020). Habitual dietary fibre and prebiotic intake is inadequate in patients with inflammatory bowel disease: findings from a multicentre cross-sectional study.. Journal of Human Nutrition and Dietetics, 34(2), 420-428.
Goodsall, T. M., Nguyen, T. M., Parker, C. E., Ma, C., Andrews, J. M., Jairath, V., & Bryant, R. V. (2021). Systematic review: Gastrointestinal ultrasound scoring indices for inflammatory bowel disease.. J Crohns Colitis, 15(1), 125-142.
Schubert, J. P., Woodman, R. J., Mangoni, A. A., Rayner, C. K., Warner, M. S., Roberts-Thomson, I. C., . . . Bryant, R. V. (2022). Geospatial analysis of Helicobacter pylori infection in South Australia: Should location influence eradication therapy?. Journal of Gastroenterology and Hepatology (Australia), 37(7), 1263-1274.
Schubert, J. P., Rayner, C. K., Costello, S. P., Roberts-Thomson, I. C., Forster, S. C., & Bryant, R. V. (2022). Helicobacter pylori: Have potential benefits been overlooked?. JGH Open, 6(11), 735-737.
Costello SP, Hughes PA, Waters O, Bryant RV, Vincent AD, Blatchford P, Katsikeros R, Makanyanga J, Campaniello MA, Mavrangelos C, Rosewarne CP, Bickley C, Peters C, Schoeman MN, Conlon MA, Roberts-Thomson IC, Andrews JM. Effect of fecal microbiota transplantation on 8-week remission in patients with ulcerative colitis: a randomized clinical trial. JAMA; 2019. 321(2): 156-164
|Investigators||Granting body||Project Title||Type of Grant||Total Grant Amount||Funding Period|
|Associate Professor Robert Bryant||The Hospital Research Foundation Group||Microbial manipulation in inflammatory bowel diseases: a novel therapeutic paradigm||Michell McGrath Fellowship||$1,875,000||2023-2028|
|Kristy Burfield, Dr Alice Day, Samantha Plush, Dr Matt Sutton, Robert Barnard, A/Prof Rob Bryant, Sangwoo Han||Flinders University South Australia||FIND-IBD; Flinders student-led interdisciplinary nutrition, mental health, and physical performance screening for holistic care planning in inflammatory bowel disease in a tertiary outpatient setting.||NEXUS Grant||$10,000||2023-2024|
|Prof Guy Maddern, Professor Tim Price, A/Prof Rob Bryant, Dr Sam Costello, Dr Virginie Gaget, Dr L Kuan, Dr Hugh, A/Prof Afzali||MRFF||Faecal microbiota transplantation to improve pain, symptoms management and treatment efficacy in patients with pancreatic cancer||Pancreatic Cancer Research Stream||$1,521,831||2023-2026|
|Dr Alice Day, A/Prof Robert Bryant, Dr Sam Costello, Prof Peter Gibson, Dr Sam Forster, Dr CK Yao, Prof Chris Probert, Malcolm Hebblewhite||The Gutsy Group||Examining a Sulphide-Reducing Diet as Therapy in Ulcerative Colitis: A Randomised, Single-Blind, Placebo-Controlled Dietary Advice Trial (EAT-UC RCT||Project grant||$150,000||2022-2025|
|Dr Alice Day, A/Prof Robert Bryant, Dr Sam Costello, Prof Peter Gibson, Dr Sam Forster, Dr CK Yao, Dr Tom Goodsall, Prof Chris Probert, Malcolm Hebblewhite||European Crohn’s Colitis Organisation||Examining a novel sulphide-reducing diet As Therapy in Ulcerative Colitis (EAT-UC trial)||Project grant||€80,000 ($130,000)||2021-2022|
|A/Prof Rob Bryant, Dr Alice Day, Dr Sam Costello, Prof Peter Gibson, Dr Sam Forster, Dr CK Yao||The Hospital Research Foundation Group||The 4-SURE project: pioneering a new diet paradigm in the management of ulcerative colitis||Project grant||$129,980||2020-2023|
Industry collaboration with Microbiotica announced on 21 June 2018.
|Associate Professor Sam Forster||Research Group Head, Microbiota and Systems Biology||Hudson Institute of Medical Research,|
|Melbourne, Cambridge||Australia, UK|
|Professor Peter Gibson||Professor of Gastroenterology||Monash University||Melbourne||Australia|
|Professor Chris Probert||Professor of Gastroenterology||Liverpool University||Liverpool||UK|
|Professor Michael Kamm||Kamm Research Group Lead & Gastroenterologist||University of Melbourne||Melbourne||Australia|
|Dr Emma Halmos||Adjunct Senior Research Fellow||Monash University||Melbourne||Australia|
|Dr CK Yao||Adjunct Senior Research Fellow||Monash University||Melbourne||Australia|
|Professor Rupert Leong||Clinical Professor of Medicine||Macquarie University & University of Sydney||Sydney||Australia|
|Associate Professor Jakob Begun||IBD Group leader in the Immunity, Infection, and Inflammation Program||Mater Research University of Queensland||Brisbane||Australia|
|Philip Weinstein||Professorial Research Fellow School of Public Health; Adjunct Professor Biological Sciences||The University of Adelaide||Adelaide||Australia|
|Professor Christopher Rayner||Gwendolyn Michell Professor, Adelaide Medical School||The University of Adelaide||Adelaide||Australia|
|Dr Hannah Wardill||Supportive Oncology Group Lead||The University of Adelaide||Adelaide||Australia|
|Dr Trevor Lawley||Group Leader of Lawley Lab||Wellcome Sanger Institute||Cambridge||UK|
|Professor Simon Travis||Professor of Clinical Gastroenterology||University of Oxford||Oxford||UK|
|Dr Vipul Jairath||Professor of Medicine||Alimentiv Clincial Trials||London, Ontario||UK, Canada|
|Dr Christopher Ma||Senior Medical Director||Alimentiv Clincial Trials||London, Ontario||UK, Canada|
|Professor Saravana Kumar||Professor in Allied Health and Health Services Research||University of South Australia||Adelaide||Australia|
|Dr Sarah Saxon||Consultant Pathologist||SA Pathology & Royal Adelaide Hospital||Adelaide||Australia|
|Associate Professor Lorraine Mackenzie||Associate Research Professor||Basil Hetzel Institute||Adelaide||Australia|
|Associate Professor Sarah Vreugde||Senior Scientist||Basil Hetzel Institute||Adelaide||Australia|