Interpretation of bowel sounds (BS) provides a convenient and non-invasive technique to aid in the diagnosis of gastrointestinal (GI) conditions. However, the approach’s potential is limited by variation between BS and their irregular occurrence. A short, manual auscultation is sufficient to aid in diagnosis of only a few conditions. A longer recording has the potential to unlock additional understanding of GI physiology and clinical utility. In this paper, a low-cost and straightforward piezoelectric acoustic sensing device was designed and used for long BS recordings. The migrating motor complex (MMC) cycle was detected using this device and the sound index as the biomarker for MMC phases. This cycle of recurring motility is typically measured using expensive and invasive equipment. We also used our recordings to develop an improved categorization system for BS. Five different types of BS were extracted: the single burst, multiple bursts, continuous random sound, harmonic sound, and their combination. Their acoustic characteristics and distribution are described. The quantities of different BS during two-hour recordings varied considerably from person to person, while the proportions of different types were consistent. The sensing devices provide a useful tool for MMC detection and study of GI physiology and function.
INTRODUCTION:
Irritable bowel syndrome (IBS) is a common and debilitating disorder estimated to affect approximately 11% of the world's population. Typically, IBS is a diagnosis of exclusion after patients undergo a costly and invasive colonoscopy to exclude organic disease. Clinician's and researchers have identified a need for a new cost-effective, accurate, and noninvasive diagnostic test for IBS.
METHODS:
Using a diagnostic case-control study, we explored the use of bowel sounds to characterize IBS with a view to diagnostic use. We recruited participants with an existing clinical diagnosis of IBS or healthy (asymptomatic) digestive systems. We recorded bowel sounds for 2 hours after fasting and then for 40 minutes after a standard meal.
RESULTS:
We here report our results including our accuracy in characterizing IBS-related bowel sounds and differentiation between participants with IBS and healthy participants. Leave-one-out cross-validation of our model developed using the first 31 IBS and 37 healthy participants gave 90% sensitivity and 92% specificity for IBS diagnosis. Independent testing using the next 15 IBS and 15 healthy participants demonstrated 87% sensitivity and 87% specificity for IBS diagnosis.
CONCLUSIONS:
These preliminary results provide proof of concept for the use of bowel sound analysis to identify IBS. A prospective study is needed to confirm these findings.
TRANSLATIONAL IMPACT:
Our belt and model offer hope of a new approach for IBS diagnosis in primary practice. Combined with screening tests for organic disease, it would offer greater confidence to patients and could reduce the burden of unnecessary colonoscopies for health care systems and patients.
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