Gastrointestinal (GI) disorders are common and often debilitating health issues that affect a significant portion of the population. Recent advancements in artificial intelligence, particularly computer vision algorithms, have shown great potential in detecting and classifying medical images. These algorithms utilize deep convolutional neural network architectures to learn complex spatial features in images and make predictions for similar unseen images. The proposed study aims to assist gastroenterologists in making more efficient and accurate diagnoses of GI patients by utilizing its two-phase transfer learning framework to identify GI diseases from endoscopic images. Three pre-trained image classification models, namely Xception, InceptionResNetV2, and VGG16, are fine-tuned on publicly available datasets of annotated endoscopic images of the GI tract. Additionally, two custom convolutional neural networks are constructed and fully trained for comparative analysis of their performance. Four different classification tasks are examined based on the endoscopic image categories. The proposed architecture employing InceptionResNetV2 achieves the most consistent and generalized performance across most classification tasks, yielding accuracy scores of 85.7% for general classification of GI tract (eight-category classification), 97.6% for three-diseases classification, 99.5% for polyp identification (binary classification), and 74.2% for binary classification of esophagitis severity on unseen endoscopic images. The results indicate the effectiveness of the two-phase transfer learning framework for clinical use to enhance the identification of GI diseases, aiding in their early diagnosis and treatment.

In vitro digestion methods have been utilized in food research to reduce in vivo studies. Although previous studies have related in vitro and in vivo data, there is no consensus on how to establish an in vitro-in vivo relationship (IVIVR) for food digestion. A framework that serves as a tool to evaluate the utility and limitations of in vitro approaches in simulating in vivo processes is proposed to develop IVIVRs for food digestion, with a focus on the gastric phase as the main location of food structural breakdown during digestion. The IVIVR consists of three quantitative levels (A, B, and C) and a qualitative level (D), which relate gastric digestion kinetic data on a point-to-point basis, parameters derived from gastric digestion kinetic data, in vitro gastric digestion parameters with in vivo absorption or appearance parameters, and in vitro and in vivo trends, respectively. Level A, B, and C IVIVRs can be used to statistically determine the agreement between in vitro and in vivo data. Level A and B IVIVRs can be utilized further evaluate the accuracy of the in vitro approach to mimic in vivo processes. To exemplify the utilization of this framework, case studies are provided using previously published static and dynamic gastric in vitro digestion data and in vivo animal study data. Future food digestion studies designed to establish IVIVRs should be conducted to refine and improve the current framework, and to improve in vitro digestion approaches to better mimic in vivo phenomena.

Imaging techniques play a crucial role in the modern era of medicine, particularly in gastroenterology. Nowadays, various non-invasive and invasive imaging modalities are being routinely employed to evaluate different gastrointestinal (GI) diseases. However, many instrumental as well as clinical issues are arising in the area of modern GI imaging. This minireview article aims to briefly overview the clinical issues and challenges encountered in imaging GI diseases while highlighting our experience in the field. We also summarize the advances in clinically available diagnostic methods for evaluating different diseases of the GI tract and demonstrate our experience in the area. In conclusion, almost all imaging techniques used in imaging GI diseases can also raise many challenges that necessitate careful consideration and profound expertise in this field.

Non-intrusive imaging of gastrointestinal (GI) tract using computed tomography (CT) contrast agents is of the most significant issues in the diagnosis and treatment of GI diseases. Moreover, spectral CT, which can generate monochromatic images to display the X-ray attenuation characteristics of contrast agents, provides a better imaging sensitivity for diagnose inflammatory bowel disease (IBD) than convention CT imaging.

Herein, a convenient and one-pot synthesis method is provided for the fabrication of small-molecule lanthanide complex Holmium-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (Ho-DOTA) as a biosafe and high-performance spectral CT contrast agent for GI imaging with IBD. In vivo CT imaging was administered with both healthy mice and colitis mice induced by dextran sodium sulfate.

We found that Ho-DOTA accumulated in inflammation sites of large intestines and produced high CT contrast compared with healthy mice. Both in vitro and in vivo experimental results also showed that Ho-DOTA provided much more diagnostic sensitivity and accuracy due to the excellent X-ray attenuation characteristics of Ho-DOTA compared with clinical iodinate agent. Furthermore, the proposed contrast media could be timely excreted from the body via the urinary and digestive system, keeping away from the potential side effects due to long-term retention in vivo.

Accordingly, Ho-DOTA with excellent biocompatibility can be useful as a potential high-performance spectral CT contrast agent for further clinical imaging of gastrointestinal tract and diagnosis of intestinal system diseases.

Bismuth-based compounds are considered to be the best candidates for computed tomography (CT) imaging of gastrointestinal (GI) tract due to high X-ray absorption. Here, we report the introduction of polymer-coated bismuth oxychloride (BiOCl) nanosheets for highly efficient CT imaging in healthy mice and animal with colitis. We demonstrate simple, low cost and fast aqueous synthesis protocol which provides gram-quantity yield of chemically stable BiOCl nanosheets. The developed contrast gives 2.55-fold better CT enhancement compared to conventional contrast with negligible in vivo toxicity. As a major finding we report a regioselective CT imaging of GI tract by using nanoparticles coated with differentially charged polymers. Coating of nanoparticles with a positively charged polymer leads to their fast accumulation in small intestine, while the coating with negatively charged polymers stimulates prolonged stomach retention. We propose that this effect may be explained by a pH-controlled aggregation of nanoparticles in stomach. This feature may become the basis for advancement in clinical diagnosis of entire GI tract.

The diagnosis of gastrointestinal (GI) tract diseases is frequently performed in the clinic, so it is crucial to develop high-performance contrast agents for real-time and non-invasive imaging examination of the GI tract. Herein, we show a novel method to synthesize a neodymium (Nd) chelate, Nd-diethylenetriaminepentaacetic acid (Nd-DTPA), on a large scale without byproducts for spectral computed tomography (CT) and second near-infrared window imaging of the GI tract in vivo. The Nd-DTPA was simply generated by heating the mixture of Nd2O3 and DTPA in water at 85 °C for 2 h. This dual-modal imaging agent has the advantages of a simple and green synthesis route, no need of purification process, high yield (86.24%), large-scale production capability (>10 g in lab synthesis), good chemical stability and excellent water solubility (≈2 g mL-1). Moreover, the Nd-DTPA emitted strong near-infrared fluorescence at 1308 nm, and exhibited superior X-ray attenuation ability compared to clinical iohexol. The proposed Nd-DTPA can integrate the complementary merits of dual-modal imaging to realize spatial-temporal and highly sensitive imaging of the GI tract in vivo, and accurate diagnosis of the location of intestinal obstruction and monitor its recovery after surgery. The developed highly efficient method for the gram-scale synthesis of Nd-DTPA and the proposed spectral CT and second near-infrared window dual-modal imaging strategy provide a promising route for accurate visualization of the GI tract in vivo.

The central nervous system (CNS) is an important regulator of the gastrointestinal tract, and CNS dysfunction can result in significant and disabling gastrointestinal symptom manifestation. For patients with neuroimmunologic and neuroinflammatory conditions, the recognition of gastrointestinal symptoms is under-appreciated, yet the gastrointestinal manifestations have a dramatic impact on quality of life. The current treatment strategies, often employed independently by the neurologist and gastroenterologist, raise the question of whether such patients are being treated optimally when siloed in one specialty. Neuroimmunogastroenterology lies at the borderlands of medical specialties, and there are few resources to guide neurologists in this area. Here, we provide an overview highlighting the potential mechanisms of crosstalk between immune-mediated neurological disorders and gastrointestinal dysfunction.

The non-invasive imaging of the gastrointestinal (GI) tract is highly desired for clinical research due to the various GI tract bacterial infection-induced diseases. To treat GI tract infections, various antibiotics have been used in the clinic. The growing problem of multidrug-resistant bacteria calls for effective antibiotic alternatives. Here, we construct a dual-functional Bi₂S₃@mSiO₂@Ag nanocomposite for simultaneous enhanced X-ray computed tomography (CT) imaging and efficient antibacterial activity in the GI tract. The nanocomposite also has good stability, low cytotoxicity, and negligible hemolysis. Moreover, the investigation of the long-term toxicity and biodistribution of the Bi₂S₃@mSiO₂@Ag nanocomposite after oral administration confirms its safety at the tested dosage. In particular, Ag nanoparticles (NPs) well dispersed on a silica substrate can reduce the antibacterial dosage and enhance the antibacterial activity of the Bi₂S₃@mSiO₂@Ag nanocomposite. Furthermore, we have established bacterially infected enteritis animal models to confirm the antibacterial ability of the nanocomposite. This work opens up a new avenue for the design of a nanotheranostic agent that acts as both a contrast agent for the enhanced visualization of the GI tract and an antibacterial agent as an alternative to antibiotics.

High-performance and biocompatible contrast agents are the key to accurate diagnosis of various diseases in vivo via CT imaging. Fabrication of pure Bi nanoparticles is the best way to maximize X-ray absorption efficiency due to the ultrahigh X-ray attenuation ability of Bi and 100% content of Bi element. However, high-quality Bi nanoparticles prepared through a facile strategy are still lacking. Herein, we report a simple noninjection method to fabricate uniformly sized pure Bi nanoparticles using only two commercial reagents by simply heating the mixture of raw materials in a short time. The obtained Bi nanoparticles owned highly uniform size, excellent monodispersity, and impressive antioxidant capacity. After being modified with oligosaccharide, the "sweet" Bi nanoprobe with comfortable patient experience and favorable biocompatibility was successfully used in CT visualization of gastrointestinal tract in detail.

Non-invasive and real-time imaging of the gastrointestinal (GI) tract is particularly desirable for research and clinical studies of patients with symptoms arising from gastrointestinal diseases. Here, we designed and fabricated silica-coated bismuth sulfide nanorods (Bi2S3@SiO2 NRs) for a non-invasive spatial-temporally imaging of the GI tract. The Bi2S3 NRs were synthesized by a facile solvothermal method and then coated with a SiO2 layer to improve their biocompatibility and stability in the harsh environments of the GI tract, such as the stomach and the small intestine. Due to their strong X-ray- and near infrared-absorption abilities, we demonstrate that, following oral administration in mice, the Bi2S3@SiO2 NRs can be used as a dual-modal contrast agent for the real-time and non-invasive visualization of NRs distribution and the GI tract via both X-ray computed tomography (CT) and photoacoustic tomography (PAT) techniques. Importantly, integration of PAT with CT provides complementary information on anatomical details with high spatial resolution. In addition, we use Caenorhabditis Elegans (C. Elegans) as a simple model organism to investigate the biological response of Bi2S3@SiO2 NRs by oral administration. The results indicate that these NRs can pass through the GI tract of C. Elegans without inducing notable toxicological effects. The above results suggest that Bi2S3@SiO2 NRs pave an alternative way for the fabrication of multi-modal contrast agents which integrate CT and PAT modalities for a direct and non-invasive visualization of the GI tract with low toxicity.

Pre-clinical studies using murine models are critical for understanding the pathophysiological mechanisms underlying immune-mediated disorders such as Eosinophilic esophagitis (EoE). In this study, an optical coherence tomography (OCT) system capable of providing three-dimensional images with axial and transverse resolutions of 5 µm and 10 µm, respectively, was utilized to obtain esophageal images from a murine model of EoE-like disease ex vivo. Structural changes in the esophagus of wild-type (Tslpr(+/+) ) and mutant (Tslpr(-/-) ) mice with EoE-like disease were quantitatively evaluated and food impaction sites in the esophagus of diseased mice were monitored using OCT. Here, the capability of OCT as a label-free imaging tool devoid of tissue-processing artifacts to effectively characterize murine EoE-like disease models has been demonstrated.

Migrating motor complex phase III (MMC phase III) of intestine is an important physiological mechanism traditionally recognized by myoelectric recordings or pressure tracings. Direct imaging is difficult and sonographic visualization in human has not been reported.

We have demonstrated this unique phenomenon in three patients who underwent abdominal sonographic examinations. Characteristic images were recorded by videotape and both spatial and temporal features were analyzed.

Occurrences of multiple equally spaced, rhythmic intestinal contractions were observed. Parameters including wave frequency, propagation velocity, and duration of the events agreed with those of the well-known phase III. The presence of distinct cyclic patterns observed in two and abolition by meal in the other patient further support our conclusion.

We conclude that the migrating waves observed in our study represent the human MMC phase III. This unique finding in human subjects merits further investigation.

Examinations with a visualisation of the anatomy and pathology of the gastrointestinal (GI) tract are often necessary for the diagnosis of GI diseases. Traditional radiology played a crucial role for many years. Endoscopy, despite some limitations, remains the main technique in the differential diagnosis and treatment of GI diseases. In the last decades, the introduction of, and advances in, non-invasive cross-sectional imaging modalities, including ultrasound (US), computed tomography (CT), positron-emission tomography (PET), and magnetic resonance imaging, as well as improvements in the resolution of imaging data, the acquisition of 3D images, and the introduction of contrast-enhancement, have modified the approach to the examination of the GI tract. Moreover, additional co-registration techniques, such as PET-CT and PET-MRI, allow multimodal data acquisition with better sensitivity and specificity in the study of tissue pathology. US has had a growing role in the development and application of the techniques for diagnosis and management of GI diseases because it is inexpensive, non-invasive, and more comfortable for the patient, and it has sufficient diagnostic accuracy to provide the clinician with image data of high temporal and spatial resolution. Moreover, Doppler and contrast-enhanced ultrasound (CEUS) add important information about blood flow. This article provides a general review of the current literature regarding imaging modalities used for the evaluation of bowel diseases, highlighting the role of US and recent developments in CEUS.

Abnormal motor patterns are implicated in many motility disorders. However, for many regions of the gut, our knowledge of normal and abnormal motility behaviors and mechanisms remains incomplete. There have been many recent advances in the development of techniques to increase our knowledge of gastrointestinal motility, some readily available while others remain confined to research centers. This review highlights a range of these recent developments and examines their potential to help diagnose and guide treatment for motility disorders.