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Thwaites PA, Slater R, Probert C, Gibson PR. Recent advances in measuring the effects of diet on gastrointestinal physiology: Sniffing luminal gases and fecal volatile organic compounds. JGH Open 2024; 8:e70006. [PMID: 39081578 PMCID: PMC11284451 DOI: 10.1002/jgh3.70006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 07/07/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024]
Abstract
Despite the huge pool of ideas on how diet can be manipulated to ameliorate or prevent illnesses, our understanding of how specific changes in diet influence the gastrointestinal tract is limited. This review aims to describe two innovative investigative techniques that are helping lift the veil of mystery about the workings of the gut. First, the gas-sensing capsule is a telemetric swallowable device that provides unique information on gastric physiology, small intestinal microbial activity, and fermentative patterns in the colon. Its ability to accurately measure regional and whole-gut transit times in ambulant humans has been confirmed. Luminal concentrations of hydrogen and carbon dioxide are measured by sampling through the gastrointestinal tract, and such application has enabled mapping of the relative amounts of fermentation of carbohydrates in proximal-versus-distal colon after manipulation of the types and amounts of dietary fiber. Second, changes in the smell of feces, via analysis of volatile organic compounds, occur in response to the diet, and by the presence and therapy of irritable bowel syndrome and inflammatory bowel disease. Such information is likely to aid our understanding of what dietary change can do to the colonic luminal microenvironment, and may value-add to diagnosis and therapeutic design. In conclusion, such methodologies enable a more complete physiological profile of the gastrointestinal tract to be created. Systematic description in various cohorts and effects of dietary interventions, particularly when co-ordinated with the analysis of microbiome, are needed.
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Affiliation(s)
- Phoebe A Thwaites
- Department of GastroenterologySchool of Translational Medicine, Monash UniversityMelbourneVictoriaAustralia
| | - Rachael Slater
- Institute of Systems, Molecules and Integrative Biology, University of LiverpoolLiverpoolUK
| | - Christopher Probert
- Institute of Systems, Molecules and Integrative Biology, University of LiverpoolLiverpoolUK
| | - Peter R Gibson
- Department of GastroenterologySchool of Translational Medicine, Monash UniversityMelbourneVictoriaAustralia
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2
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Zhou J, Thwaites PA, Gibson PR, Burgell R, Ho V. Comparison of Gas-sensing Capsule With Wireless Motility Capsule in Motility Disorder Patients. J Neurogastroenterol Motil 2024; 30:303-312. [PMID: 38972866 PMCID: PMC11238101 DOI: 10.5056/jnm23157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 07/09/2024] Open
Abstract
Background/Aims Motility disorders are prevalent, often leading to disrupted regional or whole gut transit times. In this study, we conducted a comparative analysis between the wireless motility capsule and an innovative gas-sensing capsule to evaluate regional and whole gut transit times in individuals with diagnosed motility disorders. Methods We prospectively enrolled 48 patients (34 women) diagnosed with functional dyspepsia and/or functional constipation according to Rome IV criteria. Patients ingested the capsules in tandem. We assessed the agreement between transit times recorded by both devices using Spearman correlation and Bland-Altman analysis. Additionally, diagnostic concordance between the capsules were evaluated using confusion matrices. Results We observed a significant correlation between the wireless motility capsule and the gas-sensing capsule for gastric emptying time (r = 0.79, P < 0.001) and colonic transit time (r = 0.66, P < 0.001). The gas-sensing capsule exhibited a sensitivity of 0.83, specificity of 0.96, and accuracy of 0.94 when using the standard cutoff for delayed gastric emptying (5 hours). Similarly, when applying the cutoff value for delayed colonic transit (> 59 hours), the gas-sensing capsule demonstrated a sensitivity of 0.79, specificity of 0.84, and accuracy of 0.82. Importantly, the gas-sensing capsule was well-tolerated, and no serious adverse events were reported during the study. Conclusions Our findings underscore the gas-sensing capsule's suitability as a dependable tool for assessing regional and whole gut transit times. It represents a promising alternative to the wireless motility capsule for evaluating patients with suspected motility disorders.
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Affiliation(s)
- Jerry Zhou
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Phoebe A Thwaites
- Department of Gastroenterology, Monash University, Alfred Hospital, Melbourne, VIC, Australia
| | - Peter R Gibson
- Department of Gastroenterology, Monash University, Alfred Hospital, Melbourne, VIC, Australia
| | - Rebecca Burgell
- Department of Gastroenterology, Monash University, Alfred Hospital, Melbourne, VIC, Australia
| | - Vincent Ho
- School of Medicine, Western Sydney University, Sydney, NSW, Australia
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Jalayeri Nia G, Selnes O, Cortegoso Valdivia P, Koulaouzidis A. An overview of emerging smart capsules using other-than-light technologies for colonic disease detection. Therap Adv Gastroenterol 2024; 17:17562848241255298. [PMID: 39050527 PMCID: PMC11268015 DOI: 10.1177/17562848241255298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/26/2024] [Indexed: 07/27/2024] Open
Abstract
Wireless capsule endoscopy (CE) has revolutionized gastrointestinal diagnostics, offering a non-invasive means to visualize and monitor the GI tract. This review traces the evolution of CE technology. Addressing the limitations of traditional white light (WL) CE, the paper explores non-WL technologies, integrating diverse sensing modalities and novel biomarkers to enhance diagnostic capabilities. Concluding with an assessment of Technology Readiness Levels, the paper emphasizes the transformative impact of non-WL colon CE devices on GI diagnostics, promising more precise, patient-centric, and accessible healthcare for GI disorders.
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Affiliation(s)
- Gohar Jalayeri Nia
- Department of Gastroenterology Queen Elizabeth Hospital and University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way Edgbaston Birmingham, B15 2GW, UK
| | - Ola Selnes
- Surgical Research Unit, Odense University Hospital, Svendborg, Denmark
| | - Pablo Cortegoso Valdivia
- Gastroenterology and Endoscopy Unit, University Hospital of Parma, University of Parma, Parma, Italy
| | - Anastasios Koulaouzidis
- Department of Surgery, SATC-C, OUH Svendborg Sygehus, Svendborg, Denmark
- Department of Clinical Research, University of Southern Denmark (SDU), Odense, Denmark
- Department of Social Medicine and Public Health, Pomeranian Medical University, Szczecin, Poland
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Sonu I, Oh SJ, Rao SSC. Capsules for the Diagnosis and Treatment of Gastrointestinal Motility Disorders- A Game Changer. Curr Gastroenterol Rep 2024; 26:157-165. [PMID: 38630422 DOI: 10.1007/s11894-024-00926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 05/23/2024]
Abstract
PURPOSE OF REVIEW Over the last few decades, there have been remarkable strides in endoscopy and radiological imaging that have advanced gastroenterology. However, the management of neurogastroenterological disorders has lagged behind, in part handicapped by the use of catheter-based manometry that is both non-physiological and uncomfortable. The advent of capsule technology has been a game changer for both diagnostic and therapeutic applications. RECENT FINDINGS Here, we discuss several capsule devices that are available or under investigation. There are three technologies that are FDA approved. Wireless motility capsule measures pH and pressure and provides clinically impactful information regarding gastric, small intestine and colonic transit, without radiation that has been demonstrated to guide management of gastroparesis, dyspepsia and constipation. Wireless ambulatory pH monitoring capsule is currently the gold standard for assessing gastroesophageal acid reflux. In the therapeutics arena, an orally ingested vibrating capsule has been recently FDA approved for the treatment of chronic constipation, supported by a robust phase 3 clinical trial which showed significant improvement in constipation symptoms and quality of life. There are several capsules currently under investigation. Smart capsule bacterial detection system and Capscan® are capsules that can sample fluid in the small or large bowel and provide microbiome analysis for detection of small intestinal bacterial (SIBO) or fungal overgrowth (SIFO). Another investigational gas sensing capsule analyzing hydrogen, CO2, volatile fatty acids and capsule orientation, can measure regional gut transit time and luminal gas concentrations and assess gastroparesis, constipation or SIBO. Therapeutically, other vibrating capsules are in development. Innovations in capsule technology are poised to transform our ability to investigate gut function physiologically, and non-invasively deliver targeted treatment(s), thereby providing both accurate diagnostic information and luminally-directed, safe therapy.
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Affiliation(s)
| | - Sun Jung Oh
- Johns Hopkins University, Baltimore, MD, USA
| | - Satish S C Rao
- Division of Gastroenterology and Hepatology, Medical College of Georgia, Augusta University, 1120 15th Street, BBR 2538, Augusta, GA, 30912, USA.
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5
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Suárez Terán J, Guarner Aguilar F. Small Intestinal Bacterial Overgrowth (SIBO), a clinically overdiagnosed entity? GASTROENTEROLOGIA Y HEPATOLOGIA 2024:S0210-5705(24)00148-1. [PMID: 38719183 DOI: 10.1016/j.gastrohep.2024.502190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/20/2024] [Accepted: 03/23/2024] [Indexed: 05/27/2024]
Abstract
Small intestinal bacterial overgrowth (SIBO) is a clinical entity recognized since ancient times; it represents the consequences of bacterial overgrowth in the small intestine associated with malabsorption. Recently, SIBO as a term has been popularized due to its high prevalence reported in various pathologies since the moment it is indirectly diagnosed with exhaled air tests. In the present article, the results of duodenal/jejunal aspirate culture testing as a reference diagnostic method, as well as the characteristics of the small intestinal microbiota described by culture-dependent and culture-independent techniques in SIBO, and their comparison with exhaled air testing are presented to argue about its overdiagnosis.
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Selnes O, Thorndal C, Hansen LØ, Eskemose SR, Koulaouzidis A. Conference Report: The FutuRE oF MinimalLy InvasivE GI and Capsule DiagnosTics (REFLECT) Nyborg, Denmark, October 2023. Diagnostics (Basel) 2024; 14:458. [PMID: 38472931 DOI: 10.3390/diagnostics14050458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 02/03/2024] [Indexed: 03/14/2024] Open
Abstract
The gastrointestinal (GI) tract, particularly the small bowel (SB), can be challenging for novel investigation tools [...].
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Affiliation(s)
- Ola Selnes
- Surgical Research Unit, Odense University Hospital, 5700 Svendborg, Denmark
| | - Camilla Thorndal
- Surgical Research Unit, Odense University Hospital, 5700 Svendborg, Denmark
| | | | | | - Anastasios Koulaouzidis
- Surgical Research Unit, Odense University Hospital, 5700 Svendborg, Denmark
- Department of Clinical Research, University of Southern Denmark, 5230 Odense, Denmark
- Department of Medicine, OUH Svendborg Sygehus, 5700 Svendborg, Denmark
- Department of Social Medicine and Public Health, Pomeranian Medical University, 70-204 Szczecin, Poland
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7
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Thwaites PA, Yao CK, Halmos EP, Muir JG, Burgell RE, Berean KJ, Kalantar‐zadeh K, Gibson PR. Review article: Current status and future directions of ingestible electronic devices in gastroenterology. Aliment Pharmacol Ther 2024; 59:459-474. [PMID: 38168738 PMCID: PMC10952964 DOI: 10.1111/apt.17844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/15/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Advances in microelectronics have greatly expanded the capabilities and clinical potential of ingestible electronic devices. AIM To provide an overview of the structure and potential impact of ingestible devices in development that are relevant to the gastrointestinal tract. METHODS We performed a detailed literature search to inform this narrative review. RESULTS Technical success of ingestible electronic devices relies on the ability to miniaturise the microelectronic circuits, sensors and components for interventional functions while being sufficiently powered to fulfil the intended function. These devices offer the advantages of being convenient and minimally invasive, with real-time assessment often possible and with minimal interference to normal physiology. Safety has not been a limitation, but defining and controlling device location in the gastrointestinal tract remains challenging. The success of capsule endoscopy has buoyed enthusiasm for the concepts, but few ingestible devices have reached clinical practice to date, partly due to the novelty of the information they provide and also due to the challenges of adding this novel technology to established clinical paradigms. Nonetheless, with ongoing technological advancement and as understanding of their potential impact emerges, acceptance of such technology will grow. These devices have the capacity to provide unique insight into gastrointestinal physiology and pathophysiology. Interventional functions, such as sampling of tissue or luminal contents and delivery of therapies, may further enhance their ability to sharpen gastroenterological diagnoses, monitoring and treatment. CONCLUSIONS The development of miniaturised ingestible microelectronic-based devices offers exciting prospects for enhancing gastroenterological research and the delivery of personalised, point-of-care medicine.
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Affiliation(s)
- Phoebe A. Thwaites
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Chu K. Yao
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Emma P. Halmos
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Jane G. Muir
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Rebecca E. Burgell
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
| | - Kyle J. Berean
- Atmo BiosciencesMelbourneVictoriaAustralia
- School of Engineering, RMIT UniversityMelbourneVictoriaAustralia
| | - Kourosh Kalantar‐zadeh
- Faculty of Engineering, School of Chemical and Biomolecular EngineeringThe University of SydneyCamperdownNew South WalesAustralia
| | - Peter R. Gibson
- Department of Gastroenterology, Central Clinical SchoolMonash University and Alfred HealthMelbourneVictoriaAustralia
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8
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Couper RT. The Colon Moves in Mysterious Ways. J Nutr 2024; 154:1-2. [PMID: 37716609 DOI: 10.1016/j.tjnut.2023.08.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/15/2023] [Accepted: 08/31/2023] [Indexed: 09/18/2023] Open
Affiliation(s)
- Richard Tl Couper
- Department of Paediatric Gastroenterology, Women's and Children's Hospital, University of Adelaide, Adelaide, South Australia, Australia.
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9
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Rehan M, Al-Bahadly I, Thomas DG, Young W, Cheng LK, Avci E. Smart capsules for sensing and sampling the gut: status, challenges and prospects. Gut 2023; 73:186-202. [PMID: 37734912 PMCID: PMC10715516 DOI: 10.1136/gutjnl-2023-329614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 08/26/2023] [Indexed: 09/23/2023]
Abstract
Smart capsules are developing at a tremendous pace with a promise to become effective clinical tools for the diagnosis and monitoring of gut health. This field emerged in the early 2000s with a successful translation of an endoscopic capsule from laboratory prototype to a commercially viable clinical device. Recently, this field has accelerated and expanded into various domains beyond imaging, including the measurement of gut physiological parameters such as temperature, pH, pressure and gas sensing, and the development of sampling devices for better insight into gut health. In this review, the status of smart capsules for sensing gut parameters is presented to provide a broad picture of these state-of-the-art devices while focusing on the technical and clinical challenges the devices need to overcome to realise their value in clinical settings. Smart capsules are developed to perform sensing operations throughout the length of the gut to better understand the body's response under various conditions. Furthermore, the prospects of such sensing devices are discussed that might help readers, especially health practitioners, to adapt to this inevitable transformation in healthcare. As a compliment to gut sensing smart capsules, significant amount of effort has been put into the development of robotic capsules to collect tissue biopsy and gut microbiota samples to perform in-depth analysis after capsule retrieval which will be a game changer for gut health diagnosis, and this advancement is also covered in this review. The expansion of smart capsules to robotic capsules for gut microbiota collection has opened new avenues for research with a great promise to revolutionise human health diagnosis, monitoring and intervention.
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Affiliation(s)
- Muhammad Rehan
- Department of Electronic Engineering, Sir Syed University of Engineering & Technology, Karachi, Pakistan
| | - Ibrahim Al-Bahadly
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North, New Zealand
| | - David G Thomas
- School of Agriculture and Environment, Massey University, Palmerston North, New Zealand
| | - Wayne Young
- AgResearch Ltd, Palmerston North, New Zealand
| | - Leo K Cheng
- Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
- Riddet Institute, Massey University, Palmerston North, New Zealand
| | - Ebubekir Avci
- Department of Mechanical and Electrical Engineering, Massey University, Palmerston North, New Zealand
- The MacDiarmid Institute for Advanced Materials and Nanotechnology, Wellington, New Zealand
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10
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Nandhra GK, Chaichanavichkij P, Birch M, Scott SM. Gastrointestinal Transit Times in Health as Determined Using Ingestible Capsule Systems: A Systematic Review. J Clin Med 2023; 12:5272. [PMID: 37629314 PMCID: PMC10455695 DOI: 10.3390/jcm12165272] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Ingestible capsule (IC) systems can assess gastrointestinal (GI) transit times as a surrogate for gut motility for extended periods of time within a minimally invasive, radiation-free and ambulatory setting. METHODS A literature review of IC systems and a systematic review of studies utilizing IC systems to measure GI transit times in healthy volunteers was performed. Screening for eligible studies, data extraction and bias assessments was performed by two reviewers. A narrative synthesis of the results was performed. RESULTS The literature review identified 23 different IC systems. The systematic review found 6892 records, of which 22 studies were eligible. GI transit time data were available from a total of 1885 healthy volunteers. Overall, seventeen included studies reported gastric emptying time (GET) and small intestinal transit time (SITT). Colonic transit time (CTT) was reported in nine studies and whole gut transit time (WGTT) was reported in eleven studies. GI transit times in the included studies ranged between 0.4 and 15.3 h for GET, 3.3-7 h for SITT, 15.9-28.9 h for CTT and 23.0-37.4 h for WGTT. GI transit times, notably GET, were influenced by the study protocol. CONCLUSIONS This review provides an up-to-date overview of IC systems and reference ranges for GI transit times. It also highlights the need to standardise protocols to differentiate between normal and pathological function.
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Affiliation(s)
- Gursharan Kaur Nandhra
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery & Trauma, Queen Mary University of London, London E1 4NS, UK; (P.C.); (M.B.); (S.M.S.)
- Clinical Physics, Barts Health NHS Trust, The Royal London Hospital, London E1 2BL, UK
| | - Phakanant Chaichanavichkij
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery & Trauma, Queen Mary University of London, London E1 4NS, UK; (P.C.); (M.B.); (S.M.S.)
| | - Malcolm Birch
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery & Trauma, Queen Mary University of London, London E1 4NS, UK; (P.C.); (M.B.); (S.M.S.)
- Clinical Physics, Barts Health NHS Trust, The Royal London Hospital, London E1 2BL, UK
| | - S. Mark Scott
- National Bowel Research Centre and GI Physiology Unit, Blizard Institute, Centre for Neuroscience, Surgery & Trauma, Queen Mary University of London, London E1 4NS, UK; (P.C.); (M.B.); (S.M.S.)
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11
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Ran P, Li M, Zhang K, Sun D, Lai Y, Liu W, Zhong Y, Li Z. Development and Evaluation of a Flexible PVDF-Based Balloon Sensor for Detecting Mechanical Forces at Key Esophageal Nodes in Esophageal Motility Disorders. BIOSENSORS 2023; 13:791. [PMID: 37622877 PMCID: PMC10452430 DOI: 10.3390/bios13080791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
Prevailing methods for esophageal motility assessments, such as perfusion manometry and probe-based function imaging, frequently overlook the intricate stress fields acting on the liquid-filled balloons at the forefront of the probing device within the esophageal lumen. To bridge this knowledge gap, we innovatively devised an infusible flexible balloon catheter, equipped with a quartet of PVDF piezoelectric sensors. This design, working in concert with a bespoke local key-node analytical algorithm and a sensor array state analysis model, seeks to shed new light on the dynamic mechanical characteristics at pivotal esophageal locales. To further this endeavor, we pioneered a singular closed balloon system and a complementary signal acquisition and processing system that employs a homogeneously distributed PVDF piezoelectric sensor array for the real-time monitoring of dynamic mechanical nuances in the esophageal segment. An advanced analytical model was established to scrutinize the coupled physical fields under varying degrees of balloon inflation, thereby facilitating a thorough dynamic stress examination of local esophageal nodes. Our rigorous execution of static, dynamic, and simulated swallowing experiments robustly substantiated the viability of our design, the logical coherence of our esophageal key-point stress analytical algorithm, and the potential clinical utility of a flexible esophageal key-node stress detection balloon probe outfitted with a PVDF array. This study offers a fresh lens through which esophageal motility testing can be viewed and improved upon.
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Affiliation(s)
- Peng Ran
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Chongqing 400065, China;
| | - Minchuan Li
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Chongqing 400065, China;
| | - Kunlin Zhang
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
| | - Daming Sun
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Chongqing 400065, China;
| | - Yingbing Lai
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
| | - Wei Liu
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
| | - Ying Zhong
- School of Bioinformatics, Chongqing University of Posts and Telecommunications, Chongqing 400065, China; (P.R.); (K.Z.); (D.S.); (W.L.); (Y.Z.)
| | - Zhangyong Li
- Chongqing Engineering Research Center of Medical Electronics and Information Technology, Chongqing 400065, China;
- School of Optoelectronic Engineering, Chongqing University of Posts and Telecommunications, Chongqing 400065, China
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12
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So D, Yao CK, Gill PA, Thwaites PA, Ardalan ZS, McSweeney CS, Denman SE, Chrimes AF, Muir JG, Berean KJ, Kalantar‐Zadeh K, Gibson PR. Detection of changes in regional colonic fermentation in response to supplementing a low FODMAP diet with dietary fibres by hydrogen concentrations, but not by luminal pH. Aliment Pharmacol Ther 2023; 58:417-428. [PMID: 37386938 PMCID: PMC10946934 DOI: 10.1111/apt.17629] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/04/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Carbohydrate fermentation plays a pivotal role in maintaining colonic health with excessive proximal and deficient distal fermentation being detrimental. AIMS To utilise telemetric gas- and pH-sensing capsule technologies for defining patterns of regional fermentation following dietary manipulations, alongside conventional techniques of measuring fermentation. METHODS In a double-blind crossover trial, 20 patients with irritable bowel syndrome were fed low FODMAP diets that included no extra fibre (total fibre content 24 g/day), or additional poorly fermented fibre, alone (33 g/day) or with fermentable fibre (45 g/day) for 2 weeks. Plasma and faecal biochemistry, luminal profiles defined by tandem gas- and pH-sensing capsules, and faecal microbiota were assessed. RESULTS Plasma short-chain fatty acid (SCFA) concentrations (μmol/L) were median (IQR) 121 (100-222) with fibre combination compared with 66 (44-120) with poorly fermented fibre alone (p = 0.028) and 74 (55-125) control (p = 0.069), but no differences in faecal content were observed. Luminal hydrogen concentrations (%), but not pH, were higher in distal colon (mean 4.9 [95% CI: 2.2-7.5]) with fibre combination compared with 1.8 (0.8-2.8) with poorly fermented fibre alone (p = 0.003) and 1.9 (0.7-3.1) control (p = 0.003). Relative abundances of saccharolytic fermentative bacteria were generally higher in association with supplementation with the fibre combination. CONCLUSIONS A modest increase in fermentable plus poorly fermented fibres had minor effects on faecal measures of fermentation, despite increases in plasma SCFA and abundance of fermentative bacteria, but the gas-sensing capsule, not pH-sensing capsule, detected the anticipated propagation of fermentation distally in the colon. The gas-sensing capsule technology provides unique insights into localisation of colonic fermentation. TRIAL REGISTRATION ACTRN12619000691145.
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Affiliation(s)
- Daniel So
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Chu K. Yao
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Paul A. Gill
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Phoebe A. Thwaites
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Zaid S. Ardalan
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Chris S. McSweeney
- Agriculture and FoodCommonwealth Scientific and Industrial Research OrganisationSt. LuciaAustralia
| | - Stuart E. Denman
- Agriculture and FoodCommonwealth Scientific and Industrial Research OrganisationSt. LuciaAustralia
| | - Adam F. Chrimes
- Atmo BiosciencesMelbourneAustralia
- School of Engineering, RMIT UniversityMelbourneAustralia
| | - Jane G. Muir
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
| | - Kyle J. Berean
- Atmo BiosciencesMelbourneAustralia
- School of Engineering, RMIT UniversityMelbourneAustralia
| | - Kourosh Kalantar‐Zadeh
- School of Chemical Engineering, University of New South WalesSydneyAustralia
- Faculty of EngineeringSchool of Chemical and Biomolecular Engineering, The University of SydneySydneyAustralia
| | - Peter R. Gibson
- Department of GastroenterologyCentral Clinical School, Monash University and Alfred HealthMelbourneAustralia
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Thwaites PA, Berean KJ, Gibson PR. Editorial: what is needed to achieve success in developing diagnostic technologies for patients with gastrointestinal motility disorders - past and present. Authors' reply. Aliment Pharmacol Ther 2022; 56:1617-1618. [PMID: 36352743 DOI: 10.1111/apt.17268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Phoebe A Thwaites
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Health, Melbourne, Australia
| | | | - Peter R Gibson
- Department of Gastroenterology, Central Clinical School, Monash University and Alfred Health, Melbourne, Australia
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Busam JA, Shah ED. Editorial: what is needed to achieve success in developing diagnostic technologies for patients with gastrointestinal motility disorders - past and present. Aliment Pharmacol Ther 2022; 56:1615-1616. [PMID: 36352746 DOI: 10.1111/apt.17225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jonathan A Busam
- Section of Gastroenterology and Hepatology, Dartmouth Health, Lebanon, New Hampshire, USA
| | - Eric D Shah
- Section of Gastroenterology and Hepatology, Dartmouth Health, Lebanon, New Hampshire, USA
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