Gastrointestinal endoscopy for physiological assessment in functional gastrointestinal disorders: a perspective

Area of Science:

• Gastroenterology
• Medical Diagnostics
• Physiology

Background:

• Functional gastrointestinal disorders are diagnosed using symptom-based criteria.
• Gastrointestinal endoscopy traditionally excludes organic pathology, overlooking diagnostic value in normal findings.

Purpose of the Study:

• Reposition endoscopy from a morphological exclusion tool to a dynamic physiological assessment platform.
• Establish a functional endoscopy framework to bridge structural and functional disease classification.
• Facilitate precision endoscopic phenotyping of disorders of gut-brain interaction (DGBI).

Main Methods:

• Integrate real-time intraluminal functional imaging.
• Utilize optical biopsy of mucosal microarchitecture.
• Employ neuro-immune fluorescence molecular imaging and intraluminal environmental monitoring.

Main Results:

• The proposed platform enables in situ capture of key pathophysiological parameters.
• Assessment includes gastrointestinal sensorimotor function, mucosal barrier integrity, and immune activation status.

Conclusions:

• Functional endoscopy can provide a dynamic physiological assessment.
• This approach may bridge the divide between structural and functional gastrointestinal diseases.
• Enables mechanistic phenotyping for DGBI.