Imperial College London · Falk Foundation / Guts UK Medical Student Prize 2025 · BSG Annual Meeting, Glasgow · UEG Week 2025

Award-Winning Imperial College Study Confirms Enterosgel® Adsorbs Key Inflammatory Molecules Implicated in Ulcerative Colitis

Symriti Kaur-Paneser  ·  Dr Luke Hanna  ·  Professor Nick Powell  ·  Mr Emma V Carrington  ·  Imperial College London  ·  2025

Recognised at the highest level of UK gastroenterology research

In June 2025, Symriti Kaur-Paneser was awarded the Falk Foundation / Guts UK Medical Student Prize 2025 at the British Society of Gastroenterology Annual Meeting in Glasgow — one of the most prestigious awards in UK gastroenterology for early career researchers. The prize, presented annually in partnership between the Falk Foundation and Guts UK charity, recognises outstanding research personally undertaken by medical students on intercalated degree programmes. A £1,500 prize was awarded for her study investigating Enterosgel®’s adsorption of key inflammatory molecules implicated in Ulcerative Colitis.

The study was subsequently presented as a poster abstract (PP0529) at UEG Week 2025 — the largest European gastroenterology congress — and at The Pelvic Floor Society Annual Meeting, bringing the findings to an international clinical audience.

Faecal urgency in UC: a Top 10 research priority with no good treatment

Ulcerative Colitis (UC) affects approximately 300,000 people in the UK. One of the most debilitating symptoms is faecal urgency — the sudden, uncontrollable need to reach a toilet immediately. Crucially, this symptom affects up to 50% of UC patients even when the disease is in remission and there is no active inflammation. This means that half of all people living with UC continue to experience a profoundly life-limiting symptom even when their treatment is technically working.

The James Lind Alliance — which identifies research priorities through consensus between patients, carers, and clinicians — has listed treatments for faecal urgency as one of the Top 10 research priorities for IBD. The current first-line option, loperamide, is used cautiously due to the risk of constipation and is not suitable for long-term use. Advanced therapies such as biologics and JAK inhibitors address inflammation but offer limited relief from functional bowel symptoms. There is a clear unmet need.

Could Enterosgel® selectively bind the inflammatory molecules driving UC symptoms?

Enterosgel® is already established as a clinically effective treatment for IBS with diarrhoea (IBS-D) — demonstrated in the RELIEVE IBS-D randomised controlled trial published in GUT journal in 2022. But IBS-D and UC share some overlapping mechanisms, and the question Symriti Kaur-Paneser set out to answer was whether Enterosgel®, by adsorbing key inflammatory molecules in the gut, might offer similar benefit in the UC context.

The study tested Enterosgel®’s ability to adsorb three specific molecules that are directly implicated in UC pathogenesis and symptom activity: IL-1β (interleukin-1 beta), TNF-α (tumour necrosis factor alpha), and MMP-9 (matrix metalloproteinase 9). These molecules are large — and Enterosgel®’s selectivity increases with molecular weight, making them theoretically good targets for adsorption.

How the study was conducted

The study was a laboratory-based in vitro proof of concept, conducted at Imperial College London’s Translational Colorectal Research Laboratory. Recombinant versions of the three target molecules were diluted in Enterosgel® and incubated under a range of systematically varied conditions to establish the adsorption kinetics and capacity of Enterosgel® for each molecule.

What the study found

The results were striking. Enterosgel® demonstrated rapid, concentration-dependent adsorption of all three inflammatory mediators, with the majority of binding occurring within the first 15 minutes of exposure.

A key practical finding was the dose-response relationship: doubling the gel concentration decreased residual inflammatory mediators by approximately 30%, suggesting that dose adjustment could be clinically meaningful. The adsorption plateaued by 120 minutes, consistent with the physiological transit time in the upper gastrointestinal tract.

TNF-α showed saturation at 1,000 pg/mL — an important nuance, suggesting that under conditions of very severe inflammation, Enterosgel®’s capacity to bind TNF-α may be exceeded. This is a clinically relevant observation that informs future study design and dosing strategies.

Compared to activated charcoal — a non-selective adsorbent that cannot safely be taken alongside medications — Enterosgel® showed consistently lower residual analyte levels in individual experiments, though this difference did not reach statistical significance (p=0.14), which the authors note is expected in a proof-of-concept study at this scale.

Does Enterosgel® interfere with UC medications?

The study also addressed a clinically critical secondary question: could Enterosgel® inadvertently adsorb the medications that UC patients depend on — including biologics and JAK inhibitors? This is the essential safety question that must be answered before any oral adsorbent can be considered as a complementary therapy in this patient group.

As Kaur-Paneser noted in her award citation: “Its potential to adsorb essential UC treatments, including biologics and JAK inhibitors, must also be carefully evaluated to ensure it does not interfere with their efficacy. Understanding and evaluating the interactions between Enterosgel and essential UC treatments will be crucial in determining the clinical utility of Enterosgel in UC management.” This secondary aim forms part of the ongoing research programme.

The previously published Nature Scientific Reports adsorption study (Howell, Mikhalovsky, Khovanov, 2019) demonstrated that Enterosgel® adsorbs at least ten times less of commonly prescribed small-molecule drugs than activated charcoal — a finding that supports its use alongside medications with a two-hour gap between doses. Whether this selectivity extends to the large biological molecules used in UC treatment is an important question for further study.

The prospect for patients with IBD

This study is important for several reasons. It is the first published proof-of-concept evidence that Enterosgel® can adsorb the specific inflammatory molecules that drive UC symptoms — providing, for the first time, a mechanistic rationale for investigating its use in IBD beyond IBS-D.

For patients living with UC, faecal urgency is one of the most functionally disabling aspects of the disease — affecting work, relationships, travel, and quality of life, often independently of disease activity. The prospect of a drug-free, non-absorbed, well-tolerated oral adsorbent that could address this symptom without interacting with existing treatments would represent a meaningful advance in UC management.

The authors are clear that this is a proof-of-concept study requiring further biological validation and clinical investigation. But the results provide the mechanistic foundation that justifies those next steps.