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Prof Krish Raugunath

Adjunct
Curtin Medical School

Gastroenterology Research Group

Prof. Krish Raugnath has dedicated his career to improving outcomes for people affected by oesophageal cancer, particularly through research into Barrett’s oesophagus, the only recognised pre-malignant condition linked to the disease. His interest in the field began during a research fellowship at University Hospital Aintree in Liverpool under Professor Neville Krasner, where patient experiences shaped his long-term commitment to advancing care. Now based in Perth with Curtin Medical School and Royal Perth Hospital, he established the WA Barrett’s Oesophagus Registry and continues leading research focused on earlier detection, improved surveillance, and better patient outcomes.


About

Adjunct Clinical Professor at Curtin Medical School, Curtin University, Consultant Gastroenterologist at Royal Perth Hospital, and Honorary Professor at the University of Nottingham, Prof. Krish Ragunath is an internationally recognised expert in advanced endoscopic imaging and therapeutic endoscopy.


He graduated from Madras Medical College in India and completed specialist training in gastroenterology and endoscopy in England and Wales. After undertaking clinical research at University Hospital Aintree in Liverpool, he began his clinical academic career at Nottingham University Hospitals in 2003, where he established a centre of excellence in endoscopy. He relocated to Australia in 2019 through the Global Talent initiative.


His clinical and research interests include advanced imaging of the gastrointestinal tract, endoscopic ultrasound, Barrett’s oesophagus, and minimally invasive therapies for early GI cancers. He has contributed to several key clinical guidelines, including those for Barrett’s oesophagus, upper GI endoscopy quality standards, gastric premalignant conditions, and oesophageal dilatation.


Prof. Ragunath has authored over 150 peer reviewed publications and book chapters. He serves as a faculty member of the Endoscopy Section of the Gastroenterological Society of Australia and is Associate Editor for Digestive Endoscopy, as well as an editorial board member for leading international journals. His contributions have been recognised with the British Society of Gastroenterology Hopkins Endoscopy Prize.

Email krish.ragunath@curtin.edu.au
Tel: 0410914442
ORCID
Google Scholar
Scopus
Curtin Staff Profile

Research Focus

Clinical and translational research in gastroenterology and pancreaticobiliary disorders with a particular focus on advanced endoscopic imaging of the GI Tract, in particular Barrett’s oesophagus, Endoscopic ultrasound and minimally invasive endoscopic therapy of GI disorders and early GI neoplasia.

Research Team

Dr Madoka Inoue

Research Officer

Niroshan Muwanwella

PhD Student

Sherman Picardo

PhD Student

Publications

KEY POINTS

- Effective management of Barrett’s Esophagus (BE) relies on a multidisciplinary team implementing evidence-based, standardized quality measures.
- Adhering to quality indicators, such as biopsy protocols, dysplasia detection techniques, and appropriate surveillance intervals can improve patient outcomes and reduce unnecessary procedures.
- Emerging technologies like image-enhanced endoscopy and artificial intelligence are poised to enhance personalized care and early detection of neoplastic changes.

Muwanwella, N., R. J. Haidry, and K. Ragunath., Quality Management of Barrett’s Esophagus.Gastrointestinal Endoscopy Clinics of North America 36 (1). Inpress.
ABSTRACT

Gastroparesis is a debilitating gastroduodenal disorder for which gastric peroral endoscopic myotomy (GPOEM) has emerged as an efficacious treatment option. However, response to GPOEM varies between 50% and 80%, such that preoperative predictors of treatment success are needed to guide patient selection.

METHODS:
We performed a systematic review to identify predictors of clinical and functional response to GPOEM among adult patients with gastroparesis (PROSPERO: CRD42023457359). MEDLINE, Embase, and CENTRAL databases were searched systematically for studies reporting outcomes after GPOEM in September 2023. A narrative synthesis of predictive factors on univariable and multivariable analysis was performed with consideration of response rates through meta-analysis and evaluation of discrimination if prognostic models were developed. Risk Of Bias In Non-randomized Studies - of Exposures (ROBINS-E) was used for risk of bias assessment.

RESULTS:
Of 1899 articles reviewed, 30 were included. The GPOEM response rate was 63.1% (95% confidence interval 56.3%–69.5%) with most studies defining clinical success on the basis of improvement in gastroparesis cardinal symptom index (87%, 26/30). Older age, shorter duration of gastroparesis, nondiabetic etiology, lower body mass index, and response to intrapyloric botulinum toxin were associated with positive response to GPOEM on multivariable analyses. Predictors on physiological tests such as EndoFLIP or gastric emptying scintigraphy were inconsistent. No prognostic models underwent external validation.

DISCUSSION:
Currently, there are limited reproducible predictors of response to GPOEM among patients with refractory gastroparesis. Robust prospective studies investigating scalable, reproducible, and actionable biomarkers of treatment response are required.

Varghese, C., A. Lim, C. Daker, G. Sebaratnam, A. A. Gharibans, C. N. Andrews, W. L. Hasler, G. O'Grady, J. Sujka, V. Ho, and 15 more contributors. 2025. Predictors of Outcomes after Gastric Peroral Endoscopic Myotomy for Refractory Gastroparesis: A Systematic Review.American Journal of Gastroenterology 120 (6): 1275-1284.

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