Towards Digital twins for the intestinal motility: from pathologies simulation to therapeutic strategies

Gastrointestinal motility is essential for digestion, yet its un- derlying mechanisms remain poorly understood. The move- ment of the digestive tract results from a complex interaction between electrical signals, muscle contractions, and physi- cal contact between tissues. Experimental and numerical ap- proaches provide valuable insights, but they struggle to cap- ture all these phenomena in an integrated way, especially un- der pathological or post-surgical conditions. To address this limitation, we developed a digital twin model that combines the main physical processes responsible for in- testinal movement: the electrical activity that triggers muscle contractions, the mechanical response of the intestinal wall, and contact phenomena that occur when the tissue folds, com- presses, or interacts with surrounding organs. The model is based on well-established biological and mechanical princi- ples and was implemented using open-source software. It also includes realistic boundary conditions to account for the influence of neighboring organs. The simulations successfully reproduced normal intestinal mo- tion patterns and explained the disturbances observed after surgery. Moreover, the model describes how the intestine would behave in cases of post-surgical tissue adhesions or pre-surgical pathologies such as hernias. The results show that tissue mechanical properties and contact-induced stresses strongly affect motility. In summary, this thesis provides a new approach to explore gastrointestinal disorders and represents a promising tool to support clinical decision-making before and after surgical in- terventions.