Development and Initial Clinical Evaluation of a Stress-Induced Computerized Bowel Sound Analysis System for Irritable Bowel Syndrome

This is the authors' abstract. We don't add key points for this paper.

Irritable bowel syndrome (IBS) is diagnosed using symptom-based criteria because no established physiological test objectively supports the diagnosis. We developed and evaluated a computerized bowel sound analysis system incorporating a dichotic listening task as a psychological stress challenge in three phases. In Phase 1, a short-time energy (STE)-based bowel sound extraction algorithm showed high sensitivity and specificity in technical evaluation. In Phase 2, six individuals with IBS and 10 healthy controls underwent two dichotic listening conditions in a randomized crossover study. Bowel sounds and heart-rate variability were recorded during consecutive 10-min resting, stress-loading, and recovery periods. Despite no significant between-condition differences, the condition showing numerical LF and HF increases during stress loading in participants with IBS was selected exploratorily. Using this condition, Phase 3 evaluated 15 individuals with IBS and 38 healthy controls. The percentage change in STE from rest to stress loading (rest-to-stress ΔSTE) showed an AUC of 0.79 (95% confidence interval, 0.66–0.91), with 0.80 sensitivity and 0.68 specificity at an exploratory cutoff of 20.1%. Computerized bowel sound analysis during psychological stress showed preliminary potential as a non-invasive physiological adjunct for distinguishing IBS from healthy controls. Validation in larger independent cohorts is required. J. Med. Invest. 73 : 503-518, August, 2026