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Pyloric interventions are surgical procedures employed to increase the gastric emptying rate in gastroparesis patients. In this study, we use anin silicomodel to investigate the consequences of pyloric intervention on gastric flow and emptying for two phenotypes of gastroparesis: antral hypomotility and decreased gastric tone. The transpyloric pressure gradient predicted by thein silicomodel, based on viscous fluid flow equations, is compared againstin vivomeasurements. Both phenotypes exhibit a similar pre-procedural emptying rate reduction, but after pyloric surgery, antral hypomotility case with preserved gastric tone shows significant improvements in emptying rates, up to 131%, accompanied by bile reflux from the duodenum into the stomach. Conversely, severely reduced gastric tone cases exhibited a post-procedural reduction in the net emptying rate due to the relatively larger bile reflux. In cases with a combination of antral hypomotility and reduced gastric tone, post-procedural improvements were observed only when both conditions were mild. Our findings highlight the pivotal role of the relative increase in pyloric orifice diameter in determining post-operative emptying rates. The study suggests a possible explanation for the selective response of patients toward these procedures and underscores the potential ofin silicomodelling to generate valuable insights to inform gastric surgery.

 

The peristaltic motion of stomach walls combines with the secretion of digestive enzymes to initiate the process that breaks down food. In this study, the mixing, breakdown, and emptying of a liquid meal containing protein is simulated in a model of a human stomach. In this model, pepsin, the gastric enzyme responsible for protein hydrolysis, is secreted from the proximal region of the stomach walls and allowed to react with the contents of the stomach. The velocities of the retropulsive jet induced by the peristaltic motion, the emptying rate, and the extent of hydrolysis are quantified for a control case as well as for three other cases with reduced motility of the stomach, which may result from conditions such as diabetes mellitus. This study quantifies the effect of stomach motility on the rate of food breakdown and its emptying into the duodenum and we correlate these observations with the mixing in the stomach induced by the wall motion. 

Hydrogen sulfide (H₂S) is a gaseous inflammatory mediator and important signaling molecule for maintaining gastrointestinal (GI) homeostasis. Excess intraluminal H₂S in the GI tract has been implicated in inflammatory bowel disease and neurodegenerative disorders; however, the role of H₂S in disease pathogenesis and progression is unclear. Herein, an electrochemical gas‐sensing ingestible capsule is developed to enable real‐time, wireless amperometric measurement of H₂S in GI conditions. A gold (Au) three‐electrode sensor is modified with a Nafion solid‐polymer electrolyte (Nafion‐Au) to enhance selectivity toward H₂S in humid environments. The Nafion‐Au sensor‐integrated capsule shows a linear current response in H₂S concentration ranging from 0.21 to 4.5 ppm (R²= 0.954) with a normalized sensitivity of 12.4% ppm⁻¹when evaluated in a benchtop setting. The sensor proves highly selective toward H₂S in the presence of known interferent gases, such as hydrogen (H₂), with a selectivity ratio of H₂S:H₂= 1340, as well as toward methane (CH₄) and carbon dioxide (CO₂). The packaged capsule demonstrates reliable wireless communication through abdominal tissue analogues, comparable to GI dielectric properties. Also, an assessment of sensor drift and threshold‐based notification is investigated, showing potential for in vivo application. Thus, the developed H₂S capsule platform provides an analytical tool to uncover the complex biology‐modulating effects of intraluminal H₂S.