November 16, 2023.

An editorial published in the journal Alimentary Pharmacology and Therapeutics describes Atmo Biosciences’ gas-sensing capsule as disruptive technology that has enabled unlocking of key aspects of microbial metabolism, especially with respect to carbohydrate fermentation.

The editorial, written by research dietician Daniel So, was in response to an editorial written by Professor Robin Spiller commenting on a published study by Dr. So and others about the impact of dietary fiber interventions and a low FODMAP diet on regional colonic fermentation.

In his editorial, Professor Spiller described the study as “a step change in our approach to colonic fermentation allowing us to assess regional fermentation and how dietary fibres interact with fermentable substrates”.

Writing in reply, Dr. So said the principal reason the step change had not happened before now, was because of the “inability to assess the colonic distribution of carbohydrate fermentation and directly measure its end-products in the ambulant human”.

He wrote: “The emergence of telemetric gas-sensing capsule technology,¹ alongside advances in magnetic resonance imaging techniques championed by Professor Spiller’s group,² are disruptive technologies that have enabled unlocking of key aspects of microbial metabolism, especially with respect to carbohydrate fermentation. Hence, the colonic distribution of carbohydrate metabolism and its change in response to dietary or other therapeutic manipulation can now be demonstrated.”

“Thus, application of gas-sensing capsule technology offers the opportunity to explore colonic fermentation in ways that were previously not possible. As noted by Professor Spiller, it can be used to explore how administration of specific types and various combinations of indigestible carbohydrates drive and suppress fermentation, to provide mechanistic insight into gastrointestinal tolerability of foods and, importantly, objective measures of the effects of diet therapies.

“These capsules may even play a role in ‘personalised medicine’, where ‘treatment’, such as supplementation of specific fibres, may be prescribed to a patient guided by the baseline gas-sensing capsule-derived regional fermentation patterns, in order to promote a more balanced distribution of fermentation.”³

Dr. So went on to note that “although exciting, gas-sensing capsule technology and the use of luminal hydrogen concentrations as a measure of fermentation are novel concepts and need to be further interrogated before being applied widely.”

The Atmo Gas Capsule is currently an investigational device exclusively for use in clinical investigations and is not available for sale.

Since the original study was published, Dr. So has now taken up a position with Atmo Biosciences as a clinical research associate.

1. Kalantar-Zadeh K, Berean KJ, Ha N, Chrimes AF, Xu K, Grando D, et al. A human pilot trial of ingestible electronic capsules capable of sensing different gases in the gut. Nat Electron. 2018; 1: 79–87.
2. Gunn D, Topan R, Barnard L, Fried R, Holloway I, Brindle R, et al. Randomised, placebo-controlled trial and meta-analysis show benefit of ondansetron for irritable bowel syndrome with diarrhoea: the TRITON trial. Aliment Pharmacol Ther. 2023; 57: 1258–1271.
3. So D, Gibson PR, Muir JG, Yao CK. Dietary fibres and IBS: translating functional characteristics to clinical value in the era of personalised medicine. Gut. 2021; 70: 2383–2394.