Comparison of gastrointestinal landmarks using the gas‐sensing capsule and wireless motility capsule

Abstract

Background: Accurate definition of the gastroduodenal and ileocaecal junctions (GDJ, ICJ) is essential for the measurement of regional transit times. Aims:To compare the assessment of these landmarks using the novel gas-sensing capsule and validated wireless motility capsule (WMC), and to evaluate intra-subject variance in transit times Methods: Healthy subjects ingested the gas-sensing capsule and WMC tandemly in random order. Inter-observer agreement was evaluated by intra-class correlation coefficient (ICC). Agreement between the paired devices' transit times was assessed using Bland-Altman analysis; coefficient of variation was performed to express intraindividual variance in transit times. Similar analyses were completed with tandemly ingested gas-sensing capsules. Results:The inter-observer agreement for landmarks for both capsules was excellent (mean ICC ≥0.97) in 50 studies. The GDJ was identifiable in 92% of the gas-sensing capsule studies versus 82% of the WMC studies (p = 0.27); the ICJ in 96% versus 84%, respectively (p = 0.11). In the primary cohort (n = 26), median regional transit times differed by less than 6 min between paired capsules. Bland-Altman revealed a bias of −0.12 (95% limits of agreement, −0.94 to 0.70) hours for GDJ and − 0.446 (−2.86 to 2.0) hours for ICJ. Similar results were found in a demographically distinct validation cohort (n = 24). For tandemly ingested gas-sensing capsules, coefficients of variation of transit times were 11%-35%, which were similar to variance between the paired gas-sensing capsule and WMC, as were the biases. The capsules were well tolerated.Conclusions: Key anatomical landmarks are accurately identified with the gas-sensing capsule in healthy individuals. Intra-individual differences in transit times between capsules are probably due to physiological factors. Studies in populations with gastrointestinal diseases are now required.

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

“…Colonic transit time was calculated from the time each capsule reached the ileocaecal junction to its excretion, as previously reported and validated 22,23 . Colonic pH was examined as an average across the entire colon, together with nadir and peak pH and their timing after the ileocaecal valve.…”

Editorial: what is needed to achieve success in developing diagnostic technologies for patients with gastrointestinal motility disorders ‐ past and present

“…Thwaites et al reported the development of an investigational gas‐sensing capsule to inform gastrointestinal transit times based on differences in regional production of luminal gas contents. Their report provides prospective comparative data between the gas‐sensing capsule and WMC in healthy subjects in support of construct validity for this novel technology 4 . This clinical trial provides insight on a novel mechanism of measuring luminal gas production to assess regional gastrointestinal transit, in contrast to WMC technology that measures transit primarily by pH.…”

“…Their report provides prospective comparative data between the gassensing capsule and WMC in healthy subjects in support of construct validity for this novel technology. 4 This clinical trial provides insight on a novel mechanism of measuring luminal gas production to assess regional gastrointestinal transit, in contrast to WMC technology that measures transit primarily by pH. This work is part of broader efforts in the gastroenterology community to reinvigorate the technology pipeline, recognising that WMC was originally FDAcleared over 15 years ago.…”

Thermomechanical Soft Actuator for Targeted Delivery of Anchoring Drug Deposits to the GI Tract

“…Sensing technologies such as optical sensing, [26] gas sensing, [27][28][29] pH sensing, [30] temperature sensing, [31] and electrochemical impedance spectroscopy (EIS) [32] have been readily integrated into ingestible capsules in recent years. These sensing modalities can give insights into the current state of inflammation in the GI tract and be used to inform active targeted drug delivery to afflicted tissue locations.…”