Body Surface Gastric Mapping Improves Diagnosis of Gastric Motility Disorders

Chronic gastroduodenal symptoms affect > 7% of adults, yet current diagnostic frameworks are challenged by limited mechanistic specificity, weak symptom correlation, and variable reproducibility. This review evaluates how body surface gastric mapping (BSGM), a non-invasive technology combining high-resolution gastric myoelectrical recording with validated symptom profiling, may improve the diagnosis and management of gastric motility disorders.

BSGM employs a high-resolution 64-electrode array to derive validated biomarkers of gastric motor function, including rhythm stability, frequency, and amplitude, alongside standardised digital symptom and psychometric profiling. A recent international consensus ('Auckland Classification v1.0'), derived from over 50 published studies and 4,500 + clinical tests, defined six BSGM phenotypes encompassing putative mechanisms of neuromuscular dysfunction, visceral hypersensitivity, centrally-mediated symptoms, and small bowel contributions. BSGM significantly increases diagnostic yield for motility disorders and appears synergistic with gastric emptying testing in joint studies. Observational data currently indicate that BSGM-guided management changes clinical decisions in ~ 80% of patients and is associated with reduced healthcare utilisation. Key benefits include capability to aid discrimination of motor vs sensory disorders, with specific phenotypes provisionally linked to differential treatment responses. Paediatric studies show concordant phenotype patterns, with BSGM dysrhythmia identified as a more severe phenotype. BSGM provides mechanism-based phenotyping that extends gastroduodenal evaluation beyond symptom classifications and gastric emptying status. Prospective validation of phenotype-guided treatment algorithms is now underway, and integrated multimodal diagnostic frameworks incorporating BSGM alongside complementary investigations are likely to reshape the clinical approach to these challenging disorders.