Professor of Medicine Advocate Health, Wake Forest Medical Center Charlotte, NC
Award: ACG Outstanding Research Award in the Functional Bowel Disease Category
Baha Moshiree, MD1, Thomas Abell, MD2, Ashok Attaluri, MD3, William Chey, MD, FACG4, Michael Cline, DO5, William L.. Hasler, MD6, Vincent Ho, MD7, Braden Kuo, MD8, Allen Lee, MD, MS9, Amir Masoud, MD10, Richard McCallum, MD, FACG11, Eamonn M.. Quigley, MD, MACG12, Irene Sarosiek, MD11, Satish SC. Rao, MD, PhD, FACG13, Mayra Sanchez, MD14, Abigail Stocker, MD2, Brian Surjanhata, MD15, Jerry Zhou, PhD7, Anthony Lembo, MD, FACG16 1Atrium Health Carolinas Medical Center, Charlotte, NC; 2University of Louisville, Louisville, KY; 3University of Kansas Health System, Olathe, KS; 4University of Michigan Health, Ann Arbor, MI; 5Cleveland Clinic, Cleveland, OH; 6Mayo Clinic Arizona, Scottsdale, AZ; 7Western Sydney University, Campbelltown, New South Wales, Australia; 8Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA; 9University of Michigan Medical School, Ann Arbor, MI; 10Hartford Healthcare/Connecticut GI, Madison, CT; 11Texas Tech University Health Sciences Center, El Paso, TX; 12Houston Methodist Hospital, Houston, TX; 13Augusta University Medical Center, Augusta, GA; 14Hartford HealthCare's Neurogastroenterology and Motility Center, Fairfield, CT; 15Massachusetts General Hospital, Harvard Medical School, Boston, MA; 16Cleveland Clinic Foundation, Cleveland, OH Introduction: Gastrointestinal (GI) dysmotility often results in abnormal transit times in multiple regions of the gut. The location and distribution of dysmotility is important for appropriate clinical management, however, symptoms alone do not accurately predict delays or their location. The Atmo Capsule is a novel diagnostic tool that can be used to objectively measure regional gut transit times in a single test. We evaluated the relationship between patients’ presenting symptoms and objectively measured GI transit time data from the Atmo Capsule across different regions of the GI tract. Methods: 209 patients with suspected GI dysmotility underwent evaluation with the Atmo Capsule. This analysis utilized data from 171 patients without protocol deviations who had valid transit measurements for all regions of the gut. Patients were categorized based on symptoms as having suspected upper GI (e.g., postprandial fullness, nausea; n=44), lower GI (e.g., chronic constipation per ROME IV criteria; n=15), or pan-GI dysmotility (n=112). Regional transit times were considered delayed as follows: gastric emptying ≥ 5 h; small bowel transit, ≥ 6 h; colonic transit, ≥ 59 h. Results: Delayed transit times were identified in 59% of patients (101/171). Of those, 33% had transit delays affecting multiple GI regions (Table 1). Patients with symptoms leading to suspicion for isolated upper or lower GI dysmotility often had transit delays beyond the suspect region. Specifically, only 14% (6/44) of patients with suspected upper GI dysmotility had isolated delayed gastric emptying; similarly, only 20% (3/15) of those with suspected lower GI dysmotility had isolated delayed colonic transit. Among patients with suspected pan-GI dysmotility, only 20% (22/112) had multi-regional transit delays. Discussion: Presenting symptoms poorly predicted the presence and distribution of transit time abnormalities. Objective testing with the Atmo Capsule revealed that transit time delays rarely corresponded to the region of suspected dysmotility and often affected multiple regions of the gut. These findings indicate that symptoms are poorly predictive of location of transit delay thus supporting the value of objective assessments of whole-gut transit and raise the possibility that other factors may be involved in symptom generation.
Figure: Delays in regional gut transit identified patients with suspected upper and/or lower GI dysmotility. Delays shown are either as isolated for the specific regions, or across multiple (>1) regions.
Disclosures: Baha Moshiree indicated no relevant financial relationships. Thomas Abell: Adept gi – Owner/Ownership Interest. Enterra Medical – Consultant. Novo Nordsk – Consultant. Nuvaira – Consultant. Up To Date – Royalties. Vanda – Consultant. Ashok Attaluri indicated no relevant financial relationships. William Chey: Ardelyx – Consultant. Atmo – Consultant. Biomerica – Consultant. Commonwealth Diagnostics International – Grant/Research Support. Coprata – Stock Options. Dieta – Stock Options. Digital Manometry – Intellectual Property/Patents. Evinature – Stock Options. FoodMarble – Stock Options. Gemelli – Consultant. Kiwi BioScience – Stock Options. Modify Health – Stock Options. My Nutrition Health – Intellectual Property/Patents. Phathom – Consultant. Rectal Expulsion Device – Intellectual Property/Patents. Redhill – Consultant. Salix – Consultant, Grant/Research Support. Takeda – Consultant. Vibrant – Consultant. Michael Cline: EVOKE Pharmaceuticals – Key Opinion Leader. Kate Farms – Key Opinion Leader. William Hasler: Alimetry Ltd. – Grant/Research Support. Atmo Biosciences – Grant/Research Support. Enterra Medical – Advisory Committee/Board Member, Grant/Research Support. Vincent Ho indicated no relevant financial relationships. Braden Kuo: Atmo – Consultant. Cindome – Consultant. ClinRx Pharma – Consultant. Evoke – Consultant. Genzynme – Consultant. GI Foundation – Consultant. Ironwood – Consultant. Medtronic – Consultant. Neurogastrx – Consultant. Novo – Consultant. Phathom – Consultant. Takeda – Consultant. Allen Lee: Atmo Biosciences – Consultant. Amir Masoud indicated no relevant financial relationships. Richard McCallum indicated no relevant financial relationships. Eamonn Quigley: Food Marble – Advisor or Review Panel Member. Irene Sarosiek indicated no relevant financial relationships. Satish Rao: Laborie Medical Technologies – Grant/Research Support. Vibrant Ltd – Advisory Committee/Board Member. Mayra Sanchez indicated no relevant financial relationships. Abigail Stocker: Atmos – Grant/Research Support. CinDome – Grant/Research Support. Enterra Medical – Grant/Research Support. Vanda Pharmaceuticals – Grant/Research Support. Brian Surjanhata indicated no relevant financial relationships. Jerry Zhou indicated no relevant financial relationships. Anthony Lembo: Allurion – Stock-publicly held company(excluding mutual/index funds). Ardeylx – Consultant. Atmo – Advisory Committee/Board Member. Bristol Myer Squibb – Stock-publicly held company(excluding mutual/index funds). GSK – Consultant. Ironwood – DSMB. J&J – Stock-publicly held company(excluding mutual/index funds). Salix – Consultant. Takeda – Consultant. Vibrant – Consultant.
Baha Moshiree, MD1, Thomas Abell, MD2, Ashok Attaluri, MD3, William Chey, MD, FACG4, Michael Cline, DO5, William L.. Hasler, MD6, Vincent Ho, MD7, Braden Kuo, MD8, Allen Lee, MD, MS9, Amir Masoud, MD10, Richard McCallum, MD, FACG11, Eamonn M.. Quigley, MD, MACG12, Irene Sarosiek, MD11, Satish SC. Rao, MD, PhD, FACG13, Mayra Sanchez, MD14, Abigail Stocker, MD2, Brian Surjanhata, MD15, Jerry Zhou, PhD7, Anthony Lembo, MD, FACG16, 42, Abnormalities in Regional Gut Transit Correspond Poorly With Presenting Gastrointestinal Symptoms, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
