Mark Fox

Contact

• workRoom W/E 1429 QMC
  Queen's Medical Centre
  Nottingham
  NG7 2UH
  UK
• work0115 924 9924 70608
• fax0115 970 9955
• mark.fox@nottingham.ac.uk

Biography

Mark Fox is Clinical Associate Professor and Honorary Consultant Gastroenterologist at the NIHR Biomedical Research Unit and Nottingham Digestive Diseases Centre, University of Nottingham. He qualified from Oxford Medical School in1994, having representing the University in the rarely attempted combination of Ballroom Dancing and Lightweight Rowing. He completed clinical training in the SE Thames region based at Guy's, St. Thomas' and Kings College Hospital in 2004; however his research career was based in Zurich Switzerland, most recently as Clinical and Research Lead of the Neurogastroenterology and Motility Research Group.

Dr. Fox's academic focus is to develop and apply new investigations to describe the complex structure and function of the gastrointestinal tract from top to tail. To this end he has been involved in the introduction of oesophageal high-resolution manometry (HRM), novel reflux studies, dynamic magnetic resonance imaging (MRI) of the stomach and the clinical assessment of anorectal continence. Insights from this technology help researchers understand how the GI tract responds to feeding and other challenges of daily life and how these responses break down in patients with GI disease.

Dr. Fox is regularly on the faculty of national and international meetings. He is the British representative on the European Society of Neuro-gastroenterology and Motility and the education committee of the United European Gastroenterology Foundation. He was scientific coordinator of the Joint International Meeting for Neurogastroenterology and Motility 2008 and chair of the HRM Working Group "Advances in Clinical Oesophageal Measurement" conference 2011 at which the new classification of oesophageal dysmotility was introduced. He is author of more than 50 academic papers, including reviews of reflux disease for the BMJ and High Resolution Manometry for Gut.

Expertise Summary

Assessment of Oesophageal and Stomach Function:

High Resolution Manometry, Advanced Reflux Monitoring (pH-impedance, wireless pH monitoring), Barostat, Scintigraphy, Magnetic Resonance Imaging (anatomic and cine)

Clinical, Translational Research:

Gastro-esophageal reflux disease, dyspepsia, food tolerance, irritable bowel syndrome

Teaching Summary

Understanding the causes of gastrointestinal symptoms in health and functional bowel disease (interaction of physical and psychologic factors)

Physiologic Measurement of Gastrointestinal function from top to tail

Investigation and treatment of gastro-oesophageal reflux disease, functional bowel disease

Research Summary

Development of a new, non-invasive methodology for assessment of gastric motor and sensory function: nutrient drink test (primary), scintigraphy (secondary), Magnetic Resonance Imaging… read more

Recent Publications

• BREDENOORD, A. J., FOX, M., KAHRILAS, P. J., PANDOLFINO, J. E., SCHWIZER, W. and SMOUT, A. J., 2012. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 57-65
• FOX, M. and SWEIS, R., 2012. Future directions in esophageal motility and function - new technology and methodology: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 48-56
• PANDOLFINO, J. and FOX, M., 2012. Ascona 2011: Proceedings of the HRM working group conference-introduction for the proceedings of the Ascona conference on advances in clinical investigation of esophageal dysmotility and reflux disease: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 1
• ROY, S., FOX, M. R., CURCIC, J., SCHWIZER, W. and PAL, A., 2012. The gastro-esophageal reflux barrier: biophysical analysis on 3D models of anatomy from magnetic resonance imaging: Neurogastroenterol Motil Neurogastroenterol Motil.

• View all publications

Current Research

• Development of a new, non-invasive methodology for assessment of gastric motor and sensory function: nutrient drink test (primary), scintigraphy (secondary), Magnetic Resonance Imaging (MRI)

• Structure & function of the gastro-esophageal junction in health and disease: studies using magnetic resonance imaging and high resolution manometry
• Cooperation with University Hospital Zurich and ETH Zurich

• Assessment and Modeling of in vivo gastric function and emptying assessed by MRI / manometry
• Cooperation with Anupam Pal PhD, All India Institute of Technology, Kanpur, India

• The effects of diet, life events and stress on gastrointestinal health
• Cooperation with Prof Ning Dai PhD, Zhejiang University, Hangzhou, China

• Application and validation of high resolution manometry in clinical practice
• HRM Consensus Group: working towards a new classification of oesophageal dysmotility

Future Research

• The gastrointestinal motor, sensory and neuro-hormonal response to eating in health and disease: studies using magnetic resonance imaging and intra-luminal pressure measurement (1) Functional Dyspepsia (2) Diabetic Gastroparesis

• Magnetic Resonance Imaging of Colonic Function in Chronic Constipation: Identifying Mechanisms, Directing Treatment

• Assessment of clinical utility and cost effectiveness of advanced physiologic and psychologic assessment as part of a specialist, multidisciplinary functional GI disease care pathway
• HTA grant: Cooperation with Manchester

• BREDENOORD, A. J., FOX, M., KAHRILAS, P. J., PANDOLFINO, J. E., SCHWIZER, W. and SMOUT, A. J., 2012. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 57-65
• FOX, M. and SWEIS, R., 2012. Future directions in esophageal motility and function - new technology and methodology: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 48-56
• PANDOLFINO, J. and FOX, M., 2012. Ascona 2011: Proceedings of the HRM working group conference-introduction for the proceedings of the Ascona conference on advances in clinical investigation of esophageal dysmotility and reflux disease: Neurogastroenterol Motil Neurogastroenterol Motil. 24 Suppl 1, 1
• ROY, S., FOX, M. R., CURCIC, J., SCHWIZER, W. and PAL, A., 2012. The gastro-esophageal reflux barrier: biophysical analysis on 3D models of anatomy from magnetic resonance imaging: Neurogastroenterol Motil Neurogastroenterol Motil.
• DAUM, C., SWEIS, R., KAUFMAN, E., FUELLEMANN, A., ANGGIANSAH, A., FRIED, M. and FOX, M., 2011. Failure to respond to physiologic challenge characterizes esophageal motility in erosive gastro-esophageal reflux disease: Neurogastroenterol Motil Neurogastroenterol Motil. 23(6), 517-e200
• FOX, M., 2011. Review article: identifying the causes of reflux events and symptoms – new approaches: Aliment Pharmacol Ther Aliment Pharmacol Ther. 33(Suppl. 1), 36-42
• FOX, M., 2011. Managing diffuse oesophageal spasm: DTB DTB. 49, 54-57
• FOX, M., THUMSHIRN, M., FRUHAUF, H., FRIED, M. and SCHWIZER, W., 2011. Determinants of fecal continence in healthy, continent subjects: a comprehensive analysis by anal manometry, rectal barostat and a stool substitute retention test: Digestion Digestion. 83(1-2), 46-53
• FRUEHAUF, H., MENNE, D., KWIATEK, M. A., FORRAS-KAUFMAN, Z., KAUFMAN, E., GOETZE, O., FRIED, M., SCHWIZER, W. and FOX, M., 2011. Inter-observer reproducibility and analysis of gastric volume measurements and gastric emptying assessed with magnetic resonance imaging: Neurogastroenterol Motil Neurogastroenterol Motil. 23(9), 854-61
• SWEIS, R., FOX, M., ANGGIANSAH, A. and WONG, T., 2011. Prolonged, wireless pH-studies have a high diagnostic yield in patients with reflux symptoms and negative 24-h catheter-based pH-studies: Neurogastroenterol Motil Neurogastroenterol Motil. 23(5), 419-26
• CURCIC, J., FOX, M., KAUFMAN, E., FORRAS-KAUFMAN, Z., HEBBARD, G. S., ROY, S., PAL, A., SCHWIZER, W., FRIED, M., TREIER, R. and BOESIGER, P., 2010. Gastroesophageal junction: structure and function as assessed by using MR imaging: Radiology Radiology. 257(1), 115-24
• HEINRICH, H., GOETZE, O., MENNE, D., ITEN, P. X., FRUEHAUF, H., VAVRICKA, S. R., SCHWIZER, W., FRIED, M. and FOX, M., 2010. Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: randomised controlled crossover trial: BMJ BMJ. 341, c6731
• ZHAO, J., FOX, M., CONG, Y., CHU, H., SHANG, Y., FRIED, M. and DAI, N., 2010. Lactose intolerance in patients with chronic functional diarrhoea: the role of small intestinal bacterial overgrowth: Aliment Pharmacol Ther Aliment Pharmacol Ther. 31(8), 892-900
• FOX, M. R. and GUBLER, C., 2009. Struck dysphagic: Gastroenterology Gastroenterology. 137(3), e9-10
• FRUEHAUF, H., STEINGOETTER, A., FOX, M. R., KWIATEK, M. A., BOESIGER, P., SCHWIZER, W., FRIED, M., THUMSHIRN, M. and GOETZE, O., 2009. Characterization of gastric volume responses and liquid emptying in functional dyspepsia and health by MRI or barostat and simultaneous C-acetate breath test: Neurogastroenterol Motil Neurogastroenterol Motil. 21(7), 697-e37
• GOETZE, O., FOX, M., KWIATEK, M. A., TREIER, R., SCHWIZER, W., THUMSHIRN, M., FRIED, M. and FRUEHAUF, H., 2009. Effects of postgastric 13C-acetate processing on measurement of gastric emptying: a systematic investigation in health: Neurogastroenterol Motil Neurogastroenterol Motil. 21(10), 1047-e85
• GOETZE, O., TREIER, R., FOX, M., STEINGOETTER, A., FRIED, M., BOESIGER, P. and SCHWIZER, W., 2009. The effect of gastric secretion on gastric physiology and emptying in the fasted and fed state assessed by magnetic resonance imaging: Neurogastroenterol Motil Neurogastroenterol Motil. 21(7), 725-e42
• KWIATEK, M. A., FOX, M. R., STEINGOETTER, A., MENNE, D., PAL, A., FRUEHAUF, H., KAUFMAN, E., FORRAS-KAUFMAN, Z., BRASSEUR, J. G., GOETZE, O., HEBBARD, G. S., BOESIGER, P., THUMSHIRN, M., FRIED, M. and SCHWIZER, W., 2009. Effects of clonidine and sumatriptan on postprandial gastric volume response, antral contraction waves and emptying: an MRI study: Neurogastroenterol Motil Neurogastroenterol Motil. 21(9), 928-e71
• KWIATEK, M. A., MENNE, D., STEINGOETTER, A., GOETZE, O., FORRAS-KAUFMAN, Z., KAUFMAN, E., FRUEHAUF, H., BOESIGER, P., FRIED, M., SCHWIZER, W. and FOX, M. R., 2009. Effect of meal volume and calorie load on postprandial gastric function and emptying: studies under physiological conditions by combined fiber-optic pressure measurement and MRI: Am J Physiol Gastrointest Liver Physiol Am J Physiol Gastrointest Liver Physiol. 297(5), G894-901
• PANDOLFINO, J. E., FOX, M. R., BREDENOORD, A. J. and KAHRILAS, P. J., 2009. High-resolution manometry in clinical practice: utilizing pressure topography to classify oesophageal motility abnormalities: Neurogastroenterol Motil Neurogastroenterol Motil. 21(8), 796-806
• SWEIS, R., FOX, M., ANGGIANSAH, R., ANGGIANSAH, A., BASAVARAJU, K., CANAVAN, R. and WONG, T., 2009. Patient acceptance and clinical impact of Bravo monitoring in patients with previous failed catheter-based studies: Aliment Pharmacol Ther Aliment Pharmacol Ther. 29(6), 669-76
• FOX, M. and BREDENOORD, A. J., 2008. High resolution manometry: moving from research into clinical practice: Gut Gut. 57, 405-423
• FOX, M. and SCHWIZER, W., 2008. Making sense of oesophageal contents: Gut Gut. 57(4), 435-8
• GHOSH, S. K., JANIAK, P., FOX, M., SCHWIZER, W., HEBBARD, G. S. and BRASSEUR, J. G., 2008. Physiology of the oesophageal transition zone in the presence of chronic bolus retention: studies using concurrent high resolution manometry and digital fluoroscopy: Neurogastroenterol Motil Neurogastroenterol Motil. 20(7), 750-9
• GRUBEL, C., BOROVICKA, J., SCHWIZER, W., FOX, M. and HEBBARD, G., 2008. Diffuse esophageal spasm: Am J Gastroenterol Am J Gastroenterol. 103(2), 450-7
• TREIER, R., STEINGOETTER, A., GOETZE, O., FOX, M., FRIED, M., SCHWIZER, W. and BOESIGER, P., 2008. Fast and optimized T1 mapping technique for the noninvasive quantification of gastric secretion: J Magn Reson Imaging J Magn Reson Imaging. 28(1), 96-102
• FOX, M., BARR, C., NOLAN, S., LOMER, M., ANGGIANSAH, A. and WONG, T., 2007. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms: Clin Gastroenterol Hepatol Clin Gastroenterol Hepatol. 5(4), 439-444
• FOX, M., SWEIS, R., WONG, T. and ANGGIANSAH, A., 2007. Sildenafil relieves symptoms and normalizes motility in patients with oesophageal spasm: a report of two cases: Neurogastroenterol Motil Neurogastroenterol Motil. 19(10), 798-803
• JANIAK, P., THUMSHIRN, M., MENNE, D., FOX, M., HALIM, S., FRIED, M., BRUHLMANN, P., DISTLER, O. and SCHWIZER, W., 2007. Clinical trial: the effects of adding ranitidine at night to twice daily omeprazole therapy on nocturnal acid breakthrough and acid reflux in patients with systemic sclerosis--a randomized controlled, cross-over trial: Aliment Pharmacol Ther Aliment Pharmacol Ther. 26(9), 1259-65
• SCARPULLA, G., CAMILLERI, S., GALANTE, P., MANGANARO, M. and FOX, M., 2007. The impact of prolonged pH measurements on the diagnosis of gastro-esophageal reflux disease: four day wireless pH studies: Am J Gastroenterol Am J Gastroenterol. 102, 1-6
• FOX, M. and FORGACS, I., 2006. Gastro-oesophageal reflux disease: BMJ BMJ. 332, 88-93
• FOX, M. and FORGACS, I., 2006. Unexplained (non-cardiac) chest pain: Clin Med Clin Med. 6(5), 445-9
• FOX, M., MENNE, D., STUTZ, B., FRIED, M. and SCHWIZER, W., 2006. The effects of tegaserod on oesophageal function and bolus transport in healthy volunteers: studies using concurrent high-resolution manometry and videofluoroscopy: Aliment Pharmacol Ther Aliment Pharmacol Ther. 24(7), 1017-27
• FOX, M., THUMSHIRN, M., FRIED, M. and SCHWIZER, W., 2006. Barostat measurement of rectal compliance and capacity: Dis Colon Rectum Dis Colon Rectum. 49(3), 360-70
• FOX, M., YOUNG, A., ANGGIANSAH, A., ANGGIANSAH, R. and SANDERSON, J., 2006. Interactive case report: A 22 year old man with persistent regurgitation and vomiting: BMJ BMJ. presentation 332: 1438, development 332: 1496, outcome 333: 133,
• SCHWIZER, W., STEINGOETTER, A. and FOX, M., 2006. Magnetic resonance imaging for the assessment of gastrointestinal function: Scand J Gastroenterol Scand J Gastroenterol. 41(11), 1245-60
• STEINGOETTER, A., FOX, M., TREIER, R., WEISHAUPT, D., MARINCEK, B., BOESIGER, P., FRIED, M. and SCHWIZER, W., 2006. Effects of posture on the physiology of gastric emptying: a magnetic resonance imaging study: Scand J Gastroenterol Scand J Gastroenterol. 41(10), 1155-64
• FOX, M., SCHWIZER, W. and FRIED, M., 2005. The analysis of gastric volume measurement by SPECT: gastric structure vs. function: Gastroenterology Gastroenterology. 128(5), 1533-4; author reply 1534-5
• FOX, M., STUTZ, B., MENNE, D., FRIED, M., SCHWIZER, W. and THUMSHIRN, M., 2005. The effects of loperamide on continence problems and anorectal function in obese subjects taking orlistat: Dig Dis Sci Dig Dis Sci. 50(9), 1576-83
• FOX, M., GEORGI, G., BOEHM, G., MENNE, D., FRIED, M. and THUMSHIRN, M., 2004. Dietary protein precipitation properties have effects on gastric emptying in healthy volunteers: Clin Nutr Clin Nutr. 23(4), 641-6
• FOX, M., HEBBARD, G., JANIAK, P., BRASSEUR, J. G., GHOSH, S., THUMSHIRN, M., FRIED, M. and SCHWIZER, W., 2004. High-resolution manometry predicts the success of oesophageal bolus transport and identifies clinically important abnormalities not detected by conventional manometry: Neurogastroenterol Motil Neurogastroenterol Motil. 16(5), 533-42
• FOX, M., SCHWIZER, W., MENNE, D., STUTZ, B., FRIED, M. and THUMSHIRN, M., 2004. The physical properties of rectal contents have effects on anorectal continence: insights from a study into the cause of fecal spotting on orlistat: Dis Colon Rectum Dis Colon Rectum. 47(12), 2147-56
• FOX, M., THUMSHIRN, M., MENNE, D., STUTZ, B., FRIED, M. and SCHWIZER, W., 2004. The pathophysiology of faecal spotting in obese subjects during treatment with orlistat: Aliment Pharmacol Ther Aliment Pharmacol Ther. 19(3), 311-21
• SCHWIZER, W. and FOX, M., 2004. Helicobacter pylori and gastroesophageal reflux disease: a complex organism in a complex host: J Pediatr Gastroenterol Nutr J Pediatr Gastroenterol Nutr. 38(1), 12-5
• SCHWIZER, W., FOX, M. and STEINGOTTER, A., 2003. Non-invasive investigation of gastrointestinal functions with magnetic resonance imaging: towards an "ideal" investigation of gastrointestinal function: Gut Gut. 52 Suppl 4, iv34-9
• SCHWIZER, W., STEINGOTTER, A., FOX, M., ZUR, T., THUMSHIRN, M., BOSIGER, P. and FRIED, M., 2002. Non-invasive measurement of gastric accommodation in humans: Gut Gut. 51 Suppl 1, i59-62