Bringing Gastroenterology to the 21st Century: An Exploration of the Gut-Brain Axis and Novel Digital Solutions for Patients with Gastrointestinal Disorders

Abstract

Functional gastrointestinal disorders (FGIDs) refer to gut disorders exhibiting a lack of structural, infectious, or metabolic abnormalities. Despite their widespread prevalence, current treatment does not alleviate challenges faced by patients. Previous research has identified that psychological variables, namely anxiety, depression, and adverse childhood events (ACEs), may exacerbate gastric symptoms. This study employed a mixed-methods approach to: a) investigate relationships between gut symptoms, motility, and psychological variables using a novel, non-invasive body-surface gastric mapping device and b) clinically validate an associated App using patient feedback. Ninety-seven control participants and thirty-six patients underwent motility recordings following a light meal, and completed questionnaires on gut symptoms, quality of life, anxiety, depression, optimism, and ACEs. Participants self-reported symptoms every 15 minutes in the App. In separate interviews, eight patients with FGIDs provided feedback on pictograms depicting common gut symptoms to validate the App. Results indicated significant differences between patient and control groups in gut and psychological health. On average, patients had higher anxiety and depression, abnormal gut motility, worse gut symptoms, and a lower gut-related quality of life. In particular, female gender and higher depression scores were associated with worse gut symptoms. Additionally, psychological variables, especially anxiety and depression, were associated with worse gut symptoms and certain gut motility measures across participants. The patient interviews suggested that some pictograms performed well (e.g., vomiting) and areas of improvement for other pictograms were identified. In conclusion, the gut-brain axis is a salient consideration in FGIDs, and clinicians should consider screening patients for anxiety and depression. The pictograms on the App are valuable visual tools when assessing symptoms, but the Early Satiety and Feeling Full pictograms need revision.