Simulated Colonic Feces Reveals Novel Contraction Patterns

Gregersen, Hans; Wang, Yanmin; Guo, Xiaomei; Field, F. E.; Nelson, Marjorie; Combs, William; Wang, Mengjun; Kassab, Ghassan S.

doi:10.1053/j.gastro.2020.09.055

Cited by 14 publications

(11 citation statements)

References 7 publications

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“…Fecobionics has recently been applied to the colon in a canine study [12]. From in vitro experiments in rodents and rabbits, it was well known that shallow contractions (ripples) exist [21].…”

Section: Fecobionics Assessment Of Functional Datamentioning

confidence: 99%

“…Fecobionics has been used to study defecation patterns in large animals as well as humans (normal subjects and select patients groups including patients with symptoms of obstructed defecation and fecal incontinence). Very recently, it was applied in a canine colon model for evaluation of neuromuscular function and transit patterns [12]. Novel analysis such as the rear-front pressure (preload-afterload) diagrams and quantification of defecation indices have been developed.…”

Section: Introductionmentioning

confidence: 99%

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Novel Bionics Assessment of Anorectal Mechanosensory Physiology

Gregersen

2020

Bioengineering

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Biomechatronics (bionics) is an applied science that creates interdisciplinary bonds between biology and engineering. The lower gastrointestinal (GI) tract is difficult to study but has gained interest in recent decades from a bionics point of view. Ingestible capsules that record physiological variables during GI transit have been developed and used for detailed analysis of colon transit and motility. Recently, a simulated stool named Fecobionics was developed. It has the consistency and shape of normal stool. Fecobionics records a variety of parameters including pressures, bending, and shape changes. It has been used to study defecation patterns in large animals and humans, including patients with symptoms of obstructed defecation and fecal incontinence. Recently, it was applied in a canine colon model where it revealed patterns consistent with shallow waves originating from slow waves generated by the interstitial Cells of Cajal. Novel analysis such as the “rear-front” pressure diagram and quantification of defecation indices has been developed for Fecobionics. GI research has traditionally been based on experimental approaches. Mathematical modeling is a unique way to deal with the complexity. This paper describes the Fecobionics technology, related mechano-physiological modeling analyses, and outlines perspectives for future applications.

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Section: Fecobionics Assessment Of Functional Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Novel Bionics Assessment of Anorectal Mechanosensory Physiology

Gregersen

2020

Bioengineering

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“…However, large-scale studies are required to further assess subtype phenotypes and treatment effects. Future studies may take advantage of improved wireless devices that in addition can measure the anorectal angle and the bag shape (38)(39)(40)(41)(42). Future studies may also examine the efficacy of Fecobionics as a therapeutic tool for performing biofeedback treatment in FI patients.…”

Section: Pathophysiological Aspectsmentioning

confidence: 99%

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Futaba

Chen

Leung

et al. 2022

Clin Transl Gastroenterol

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INTRODUCTION: Biofeedback therapy (BFT) is a well-known treatment for functional anorectal disorders. The effect of BFT was monitored in fecal incontinence (FI) patients with the Fecobionics test and with the conventional technologies, anorectal manometry (ARM) and balloon expulsion test (BET). METHODS:Studies were performed in 12 patients before and after 8 weeks of biofeedback training. The Fecal Incontinence Severity Index (FISI) score was obtained. Anal resting and squeeze pressures were measured before the bag was distended in the rectum until urge to defecate. Pressure recordings were made during Fecobionics evacuation. RESULTS:BFT resulted in 24% reduction in FISI scores (P < 0.01). Seven patients were characterized as responders. Anal pressures, the urge-to-defecate volume, and defecatory parameters did not change significantly during BFT. For ARM-BET, the maximum anal squeeze pressure, the urge-to-defecate volume, and the expulsion time were lower after BFT compared with those before BFT (P < 0.05).For Fecobionics, the change in urge volume (r 5 0.74, P < 0.05) and the change in defecation index (r 5 0.79, P < 0.01) were associated with the change in FISI score. None of the ARM-BET parameters were associated with the change in FISI score. It was studied whether any pre-BFT data could predict treatment success. The Fecobionics expulsion duration and the defecation index predicted the outcome (P < 0.05). The defecation index had a sensitivity of 100% and a specificity of 72%. None of the ARM-BET parameters predicted the outcome (all P > 0.2). DISCUSSION:Fecobionics was used as a tool to monitor the effect of BFT and proved better than conventional technologies for monitoring and predicting the outcome in the FISI score.

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“…Other studies have been done on patients with FI including patients with low anterior resection syndrome (LARS) and CC including obstructed defecators (Chen et al, 2021b; Gregersen et al, 2020; Gregersen, Chen, et al, 2021). Furthermore, pilot studies have been done with an early stage integrated Fecobionics prototype in colon and anorectum (Gregersen, 2020; Gregersen, Sun, et al, 2021; Gregersen, Wang, et al, 2021; Kassab et al, 2021; Sun et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, parameters like the rectoanal pressure gradient (RAPG) have been developed for ARM studies but the value of the RAPG has been disputed (Grossi et al, 2016). We designed Fecobionics to integrate important functional measures in a single test (Chen et al, 2020, 2021a, 2021b; Gregersen, 2020; Gregersen et al, 2019, 2018; Gregersen, Chen, et al, 2021; Gregersen, Sun, et al, 2021; Gregersen, Wang, et al, 2021; Kassab et al, 2021; Sun et al, 2019, 2020; Zhuang et al, 2021). The foundation was laid with the device that measured axial pressures in contrast to the radial pressures measured by ARM.…”

Section: Introductionmentioning

confidence: 99%

Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

Gregersen

Wang

Field³

et al. 2022

Physiological Reports

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Several technologies have been developed for assessing anorectal function including the act of defecation. We used a new prototype of the Fecobionics technology, a multi-sensor simulated feces, to visualize defecatory patterns and introduced new metrics for anorectal physiology assessment in normal subjects. Fourteen subjects with normal fecal incontinence and constipation questionnaire scores were studied. The 10-cm-long Fecobionics device provided measurements of axial pressures, orientation, bending, and shape. The Fecobionics bag was distended to the urge-to-defecate level inside rectum where after the subjects were asked to evacuate. Physiological evacuation parameters were assessed. Special attention was paid to the Fecobionics rectoanal pressure gradient (F-RAPG) during evacuation. Anorectal manometry (ARM) and balloon expulsion test (BET) were done as references. The user interface displayed the fine coordination between pressures, orientation, bending angle, and shape. The pressures showed that Fecobionics was expelled in 11.5 s (quartiles 7.5 and 18.8s), which was shorter than the subjectively reported expulsion time of the BET balloon. Six subjects did not expel the BET balloon within 2 min. The F-RAPG was 101 (79-131) cmH 2 O, whereas the ARM-RAPG was −28 (−5 to −47) cmH 2 0 (p < 0.001). There was no association between the two RAPGs (r 2 = 0.19). Fecobionics showed paradoxical contractions in one subject (7%) compared to 12 subjects with ARM (86%). Fecobionics obtained novel physiological data. Defecatory patterns and data are reported and can be used to guide larger-scale studies in normal subjects and patients with defecatory disorders. In accordance with other studies, this Fecobionics study questions the value of the ARM-RAPG.

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Simulated Colonic Feces Reveals Novel Contraction Patterns

Cited by 14 publications

References 7 publications

Novel Bionics Assessment of Anorectal Mechanosensory Physiology

Novel Bionics Assessment of Anorectal Mechanosensory Physiology

Fecobionics Evaluation of Biofeedback Therapy in Patients With Fecal Incontinence

Feasibility study of defecation studied with a wireless Fecobionics probe in normal subjects

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