New technologies in gastrointestinal research

Abstract

This issue presents different new techniques aiming to increase our understanding of the gastrointestinal system and to improve treatment. The technologies cover selected methods to evoke and assess gut pain, new methods for imaging and physiological measurements, histochemistry, pharmacological modelling etc. There is no doubt that the methods will revolutionize the diagnostic approach in near future.

Key Words: Pain, Gut, Brain, Sphincter, Imaging, Drug

TEXT

New technologies are emerging in gastroenterology. During the last decade, methods such as intraluminal ultrasound, other imaging modalities and high resolution manometry have become available for routine work, dramatically improving the ability to correctly diagnose and treat gastroenterological diseases. Experimental methods to assess the sphincter regions and the pain system have also become available with the possibility to get more insights into basic physiological mechanisms and understanding of how drugs affect the gastrointestinal tract. This has lead to an improvement in the treatment of patients with both organic and functional diseases. Unfortunately, many of these methods are still only available in the most advanced laboratories, but commercial systems are currently being developed with the aim of getting a more widespread use of the most promising techniques.

In the current issue of World J Gastroenterol, different techniques which are either commercially available or in development are presented. The technologies cover the selected methods to evoke and assess gut pain experimentally and in the clinic[1]; neuroimaging of the brain-gut axis[2]; new methods for ultrasound and imaging[3]; devices to assess sphincter functions and force measurements[4–6]; emerging experimental methods to measure blood flow and histochemical changes in the tissue[78]; manometry and impedance measurements as well as pharmacological and modelling techniques[910]. There is no doubt that these methods will revolutionize the diagnostic approach in near future. In particular, combining the different techniques with development of miniature equipment will lead to multimodal experimental procedures that can be done in one procedure with less discomfort and complications for the patients. Today, it is theoretically possible to combine probes for manometry, imaging, assessment of sphincter function and axial force in the oesophagus with endoscopy (including biopsies) and comprehensive testing of the pain system (including electrophysiological assessment of the brain-gut axis), all in one procedure. In the current issue, examples of such combined techniques are demonstrated. It has been shown that multimodal assessment may lead us to much a better understanding of diseases and symptoms in various patient groups. Individual genetic and environmental factors among others have now led to the understanding that patients with the same disease do not necessary respond to standard treatments. New pharmacological methods giving insight into drug mechanisms in individual patients are available and the methods provide the possibility for tailoring specific and individualized treatment in the near future. Naturally, there is still a long way to go before the ideal probes and equipment are available for general use; but with the necessary knowledge exchange and open-mindedness in the research community, there is no doubt that near future will revolutionize the way we look at the gastrointestinal tract and treat our patients.

The papers in the current issue show how innovative development and research can bring new ideas as well as refinement of older techniques into play in the gastrointestinal tract. The clinician should have at least some knowledge of these techniques as a close relationship and sharing of ideas between research and the clinic are a sine qua none to find the right indications for the methods. In the research community, there are many more emerging new methods than those dealt with in this issue; but with the main focus on the upper gastrointestinal tract, the selected techniques represent broadly the evolution and forthcoming procedures in this important field.