Body surface electrical recordings detect alterations in colonic motility and heart rate variability in irritable bowel syndrome patients

Irritable Bowel Syndrome (IBS) is a highly prevalent, commonly diagnosed gastrointestinal disorder of gut-brain interaction (DGBI) that causes substantial physical, psychological, and financial burden. The role of abnormal motility and altered autonomic nervous system function, and their interplay, remains to be fully understood. Here we present a non-invasive method using body surface electrical recordings to concurrently quantify meal-response colonic motility and heart rate variability (HRV). We demonstrate the practical utility of this new technique in a pilot study comparing colonic motility and autonomic nervous system (ANS) function in IBS patients (n=14) and healthy controls (HC; n = 22). The study protocol included a 2-3 hr body-surface electrical recording with 60-90 minutes each of pre- and post- meal epochs. Colonic motility was markedly increased in the subset of IBS patients experiencing moderate-to-severe symptoms during the study, compared to IBS no or mild symptom groups and healthy controls. HRV metrics in IBS patients showed substantial baseline shifts with decreased vagal and increased sympathetic input, with blunted autonomic meal responses compared to HC. Newly introduced dynamic trajectory maps revealed pronounced colon motility-vagal dysregulation in high symptom IBS patients but not mild or no symptom groups. These results indicate altered autonomic-motility interaction as a potential mechanism of symptom genesis in IBS patients. This technology platform offers an easy-to-apply, non-invasive tool for larger scale investigations of gut and autonomic nervous system function in healthy and gastrointestinal disease cohorts.