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The oral route is the most common choice for drug administration because of several advantages, such as convenience, low cost, and high patient compliance, and the demand and investment in research and development for oral drugs continue to grow. The rate of dissolution and gastric emptying of the dissolved active pharmaceutical ingredient (API) into the duodenum is modulated by gastric motility, physical properties of the pill, and the contents of the stomach, but current in vitro procedures for assessing dissolution of oral drugs are limited in their ability to recapitulate this process. This is particularly relevant for disease conditions, such as gastroparesis, that alter the anatomy and/or physiology of the stomach. In silico models of gastric biomechanics offer the potential for overcoming these limitations of existing methods. In the current study, we employ a biomimetic in silico simulator based on the realistic anatomy and morphology of the stomach (referred to as “StomachSim”) to investigate and quantify the effect of body posture and stomach motility on drug bioavailability. The simulations show that changes in posture can potentially have a significant (up to 83%) effect on the emptying rate of the API into the duodenum. Similarly, a reduction in antral contractility associated with gastroparesis can also be found to significantly reduce the dissolution of the pill as well as emptying of the API into the duodenum. The simulations show that for an equivalent motility index, the reduction in gastric emptying due to neuropathic gastroparesis is larger by a factor of about five compared to myopathic gastroparesis.
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This content will become publicly available on June 1, 2026
Modeling the Effect of Sleeve Gastrectomy on Gastric Digestion in Stomach: Insights From Multiphase Flow Modeling
Abstract The geometry and motility of the stomach play a critical role in the digestion of ingested liquid meals. Sleeve gastrectomy, a common type of bariatric surgery used to reduce the size of the stomach, significantly alters the stomach's anatomy and motility, which impacts gastric emptying and digestion. In this study, we use an imaging data-based computational model, StomachSim, to investigate the consequences of sleeve gastrectomy. The pre-operative stomach anatomy was derived from imaging data, and the postsleeve gastrectomy shapes were generated for different resection volumes. We investigate the effect of sleeve sizes and motility patterns on gastric mixing and emptying. Simulations were conducted using an immersed-boundary flow solver, modeling a liquid meal to analyze changes in gastric mixing and emptying rates. The results reveal that different degrees of volume reduction and impaired gastric motility have complex effects on stomach's mixing and emptying functions, which are important factors in gastric health of the patient. Specifically, the total gastric liquid emptying rates increased by 21% with a 30% volume reduction and by 51% with reductions exceeding 50%, due to altered intragastric pressure. Additionally, impaired motility functions resulted in slower mixing, leading to delayed food emptying. These findings provide insights into the biomechanical effects of sleeve gastrectomy on gastric digestion and emptying functions, highlighting the potential of computational models to inform surgical planning and postoperative management.
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- Award ID(s):
- 2019405
- PAR ID:
- 10616126
- Publisher / Repository:
- ASME
- Date Published:
- Journal Name:
- Journal of Biomechanical Engineering
- Volume:
- 147
- Issue:
- 6
- ISSN:
- 0148-0731
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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