Michael Mosley: Gut feelings

Listen carefully, the gurgles of a grumbling belly could be a cry for help.

Published: August 22, 2019 at 6:52 pm

One of my medical heroes is Prof Barry Marshall of the University of Western Australia. We met in the 1990s when I made a documentary about him and his colleague, Robin Warren. I created the film, Ulcer Wars, because they had a great story to tell: they had identified and grown a species of bacteria they called Helicobacter pylori and had become convinced that it was responsible for the majority of cases of gastric cancer and gastric ulcers.

As a film-maker, it appealed to me that in the 1980s Barry had drank from a beaker containing H. pylori. He became ill and a biopsy of his gut revealed that the H. pylori had indeed begun colonising his stomach lining and the upper part of his small intestine, causing inflammation, or gastritis. He took antibiotics, his symptoms improved and biopsies confirmed the H. pylori had gone.

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When I made Ulcer Wars there was widespread scepticism about their claims about H. pylori. That changed when the pair won the Nobel Prize in Physiology or Medicine in 2005. It was thanks to Barry’s example that I embraced my policy of on-screen self-experimentation.

I caught up with Barry recently and he showed me his latest project, which may again change our understanding of a common gut problem. His team is investigating is irritable bowel syndrome (IBS). IBS is incredibly common, affecting about 10 per cent of the world’s population. Symptoms include pain, bloating, diarrhoea and constipation. There is no simple, reliable test and many people either go undiagnosed or are dismissed as overly anxious.

So there is a lot of interest in a test that Barry’s team is developing. It uses a belt that is strapped to a patient’s stomach, encasing a small, sensitive microphone. The research is called the Noisy Guts Project.

“We wanted to find a way to listen to the rumblings and grumblings of the gut, to identify patterns that characterise chronic gut conditions like IBS,” Barry says. “We’re using acoustic sensing technology that was originally created to track the munching sounds of termites.”

They recruited volunteers, some with a diagnosis of IBS, others with healthy digestive systems, and asked them to wear the belt and have their gut sounds recorded for two hours post-fasting, and then for 40 minutes after a standardised meal.

Their gut sounds were uploaded into a computer that used machine-learning to identify differences between healthy and unhealthy guts. They then tested their system on a similar range of people, this time mixed up so the researchers didn’t know their medical histories.

The system worked well, accurately detecting IBS 87 per cent of the time, with few false positives. The team is now testing the system with large numbers of patients before bringing it to market.

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