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Multi-region sampling of the human small intestine using an ingestible device

Fu, B.; DeSchepper, L. B.; Sun, J.; McKeithen-Mead, S. A.; Kapili, B.; Ochoa-Andersen, P.; Spencer, S. P.; Fardeen, T.; Ricardo, M.; El Kamari, V.; Sinha, S.; Relman, D. A.; Grembi, J. A.; Shalon, D.; Estrela, S.; Huang, K. C.

2026-06-10 gastroenterology
10.64898/2026.06.09.26353912 medRxiv
Show abstract

The human small intestine (SI) plays a central role in nutrient processing, host-microbe interactions, and immune regulation, yet remains poorly characterized due to the lack of minimally disruptive sampling methods. Here, we present a protocol for deploying, recovering, and analyzing samples collected using an ingestible device that enables multi-region, lumen-targeted SI sampling during normal digestion. The device incorporates a ~30-cm collapsible tube wound into pH- or time-responsive layers that sequentially unfurl in situ, typically capturing three spatially ordered samples with high yield and reliable retrieval. This protocol outlines study design, participant handling, device recovery, contamination control, and standardized workflows for analyses, including cell quantification, culturomics, sequencing, and metabolomics. We further describe benchmarking approaches for evaluating spatial resolution and strategies for assay prioritization when sample volume is limiting. By reducing participant burden and facilitating integration with stool, saliva, and clinical metadata, this approach enables longitudinal and large-cohort studies linking SI microbial ecology and host physiology to human health.

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