Digital twins in gastroenterology: From computational modeling to precision medicine and clinical translation

Table 2 Summary of digital twin applications across gastrointestinal regions

GI region	Representative models/tools	Key simulation parameters	Target conditions	Potential clinical applications	Current restrictions
Stomach	StomachSim; CFD-based gastric models; dynamic MRI-coupled simulations	Antral contractions. Gastric mixing. Emptying dynamics. Intraluminal pressure. Retropulsive jets. Drug dissolution kinetics. Body posture effects	Gastroparesis; functional dyspepsia	Pre-procedural planning for pyloroplasty and sleeve gastrectomy; pharmacologic efficacy testing; dietary optimization; identification of subtle flow abnormalities	Simplified motility assumptions. Small experimental datasets. Limited patient-specific validation
Small intestine	Peristaltic flow models; CFD luminal transit simulations	Luminal flow velocities. Contractile activity. Transit dynamics. Absorption modeling	Functional bowel disorders; malabsorption states	Nutrient absorption assessment; motility characterization; drug delivery simulation	Early feasibility stage. Complex motility patterns difficult to replicate. Changing luminal content variability
Colon	Digital replicas of experimental colon models; peristaltic fluid dynamics models	Peristaltic fluid movement. Mixing patterns. Flow velocities. Luminal shear stress	Constipation; diarrheal states; colonic dysmotility	Colonic motility disorder characterization; therapeutic intervention planning; microbiome-motility interaction modeling	Validated primarily against experimental models. Minimal patient-specific clinical data. Simplified boundary conditions
Esophagus	CFD bolus transit models; sphincter biomechanical simulations	Bolus transit mechanics. Sphincter function. Intraluminal pressure gradients. Peristaltic wave propagation	Achalasia; spastic motility syndromes; gastroesophageal reflux	Diagnostic support for dysmotility; pre-interventional planning for myotomy or dilation; assessment of sphincter competence	Largely conceptual/early development. Very limited clinical validation data. Complex tissue mechanics not fully modeled

Overview of current computational modeling approaches, simulated parameters, targeted conditions, potential clinical uses, and key limitations for digital twin research across major gastrointestinal organs. CFD: Computational fluid dynamics; GI: Gastrointestinal; MRI: Magnetic resonance imaging.