Intestinal motor activity, endoluminal motion and transit

Iorio, Fosca De; Malagelada, Carolina; Azpiroz, Fernando; Maluenda, Maria D.; Violanti, C.; Igual, Laura; Vitrià, Jordi; Malagelada, Juan–R.

doi:10.1111/j.1365-2982.2009.01363.x

Cited by 20 publications

(25 citation statements)

References 16 publications

(24 reference statements)

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“…Alternative methods include the use of video capsule endoscopy 70 or magnetic pill. 71 For capsule endoscopy, analysis of endoluminal visual data, using computer vision techniques, allows for recognition of intestinal contractile patterns.…”

Section: Other Techniques For Assessment Of Sbttmentioning

confidence: 99%

“…Small bowel transit time is determined by visual detection of capsule exit from the stomach and arrival in the cecum. 70 Capsules have the advantage of simplicity, minimal discomfort and performance in ambulatory setting. Their drawbacks include that capsules are likely to empty from the stomach with resumption of fasting pattern of motility thereby providing data on small bowel transit during fasting and that their movement may not reflect that of chyme, and their retention in stomach or small bowel if lumen is obstructed may limit its use.…”

Section: Other Techniques For Assessment Of Sbttmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

Rao¹,

Camilleri²,

Hasler³

et al. 2010

Neurogastroenterology &Amp; Motility

325

296

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Background Disorders of gastrointestinal (GI) transit and motility are common, and cause either delayed or accelerated transit through the stomach, small intestine or colon, and affect one or more regions. Assessment of regional and/or whole gut transit times can provide direct measurements and diagnostic information to explain the cause of symptoms, and plan therapy. Purpose Recently, several newer diagnostic tools have become available. The American and European Neurogastroenterology and Motility Societies undertook this review to provide guidelines on the indications and optimal methods for the use of transit measurements in clinical practice. This was based on evidence of validation including performance characteristics, clinical significance, and strengths of various techniques. The tests include measurements of: gastric emptying with scintigraphy, wireless motility capsule, and 13 C breath tests; small bowel transit with breath tests, scintigraphy, and wireless motility capsule; and colonic transit with radioopaque markers, wireless motility capsule, and scintigraphy. Based on the evidence, consensus recommendations are provided for each technique and for the evaluations of regional and whole gut transit. In summary, tests of gastrointestinal transit are available and useful in the evaluation of patients with symptoms suggestive of gastrointestinal dysmotility, since they can provide objective diagnosis and a rational approach to patient management.

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Section: Other Techniques For Assessment Of Sbttmentioning

confidence: 99%

Section: Other Techniques For Assessment Of Sbttmentioning

confidence: 99%

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

Rao¹,

Camilleri²,

Hasler³

et al. 2010

Neurogastroenterology &Amp; Motility

325

296

View full text Add to dashboard Cite

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“…Computer vision automatically analyzes a series of specific features from the sequential image frames; each feature is quantitatively analyzed by specific mathematical models measuring numerical parameters. The mathematical parameters (each of which defines one feature) are then processed [26].…”

Section: Endoluminal Image Analysismentioning

confidence: 99%

The Dysfunctional Gut

Malagelada¹,

Malagelada²

2010

Curr Gastroenterol Rep

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After many decades debating whether the clinical manifestations of patients with functional digestive symptoms originate "in their minds" or "in their guts," arguments remain strong on both sides of the controversy. However, advances in understanding of gut physiology and pathophysiology, and persuasive evidence on the bidirectionality of the regulatory traffic between the enteric and central nervous systems, are helping to characterize clinical situations in which we can legitimately speak of gut dysfunction, as opposed to others where symptoms are not associated with apparent or detectable gut disturbances and may truly represent somatization of an affective disorder. In this review, we describe available clinically applicable technology, albeit in specialized clinical research units, that may be used to discern whether or not challenging patients have gut sensory or motor disturbances. The practical yield of applying such methods to diagnostic investigation may be substantial, because it establishes a plausible mechanism of disease that may be used in patient management and patient persuasion, to remove uncertainties and to prevent futile repetition of conventional diagnostic tests. By evolving from symptom analysis to mechanism-based diagnosis, our gastroenterology community may progress toward the goal of delivering the full diagnostic spectrum from altered morphology to disturbed function.

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“…At screening, potential candidates filled out a symptom questionnaire and consecutive patients fulfilling Rome III diagnostic criteria of functional bowel disorders were offered to participate in the study (10). None of these subjects had participated in any previous study on intestinal motility evaluation by capsule endoscopy (6,11,12). The study protocol was approved by the Ethics Committee of the University Hospital Vall d'Hebron, and all participants gave their written, informed consent before enrollment.…”

Section: Participantsmentioning

confidence: 99%

“…Endoluminal motion was measured by analysis of color differences (red-green-blue composition) in consecutive images by the Earth Mover's Distance method, which measures the degree of motion as the amount of work (expressed as units of Euclidian distance) necessary to transform the color plot of one frame into the following one (17). Static and high-motion images were defined with thresholds that have been previously established (6). This method was applied to measure wall motion in clear frames, as well as the motion of turbid content.…”

Section: Computer Vision Analysismentioning

confidence: 99%

Classification of functional bowel disorders by objective physiological criteria based on endoluminal image analysis

Malagelada

Drozdzal

Seguí

et al. 2015

American Journal of Physiology-Gastrointestinal and Liver Physi

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We have previously developed an original method to evaluate small bowel motor function based on computer vision analysis of endoluminal images obtained by capsule endoscopy. Our aim was to demonstrate intestinal motor abnormalities in patients with functional bowel disorders by endoluminal vision analysis. Patients with functional bowel disorders (n ϭ 205) and healthy subjects (n ϭ 136) ingested the endoscopic capsule (Pillcam-SB2, Given-Imaging) after overnight fast and 45 min after gastric exit of the capsule a liquid meal (300 ml, 1 kcal/ml) was administered. Endoluminal image analysis was performed by computer vision and machine learning techniques to define the normal range and to identify clusters of abnormal function. After training the algorithm, we used 196 patients and 48 healthy subjects, completely naive, as test set. In the test set, 51 patients (26%) were detected outside the normal range (P Ͻ 0.001 vs. 3 healthy subjects) and clustered into hypo-and hyperdynamic subgroups compared with healthy subjects. Patients with hypodynamic behavior (n ϭ 38) exhibited less luminal closure sequences (41 Ϯ 2% of the recording time vs. 61 Ϯ 2%; P Ͻ 0.001) and more static sequences (38 Ϯ 3 vs. 20 Ϯ 2%; P Ͻ 0.001); in contrast, patients with hyperdynamic behavior (n ϭ 13) had an increased proportion of luminal closure sequences (73 Ϯ 4 vs. 61 Ϯ 2%; P ϭ 0.029) and more high-motion sequences (3 Ϯ 1 vs. 0.5 Ϯ 0.1%; P Ͻ 0.001). Applying an original methodology, we have developed a novel classification of functional gut disorders based on objective, physiological criteria of small bowel function.functional bowel disorders; capsule endoscopy; intestinal motility; computer vision analysis; machine learning WE HAVE DEVELOPED AN ORIGINAL method to evaluate small bowel motor function based on computer vision analysis of endoluminal images obtained by capsule endoscopy. A series of features, such as phasic luminal closures, noncontractile patterns, e.g., smooth wall or open tunnel view, amount of chyme, and motion of the walls and content, are quantitatively measured. Each subject is then defined by a combination of values derived from these various dimensions. Definition of normality in this multidimensional space is performed by machine learning techniques: providing a large series of normal cases, the program draws the hyperplane that defines the normal range and, hence, automatically learns to discriminate what is normal and what is not (24). This may constitute a particularly valuable diagnostic tool on account of the enormous amount of data obtained in a large sample of healthy individuals and the automated algorithms that eliminate the piecemeal assessment of normality for each separate feature as well as the subjectivity of the data analyst, common to many physiological gut tests.

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Intestinal motor activity, endoluminal motion and transit

Cited by 20 publications

References 16 publications

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies

The Dysfunctional Gut

Classification of functional bowel disorders by objective physiological criteria based on endoluminal image analysis

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