Expert Clinical Consensus on Body Surface Gastric Mapping Phenotypes for Gastroduodenal Disorders: ‘Auckland Classification’ v1.0

INTRODUCTION: Chronic gastroduodenal disorders remain challenging to manage, and new diagnostic approaches are needed to better delineate underlying causes and guide therapeutic decisions. Body Surface Gastric Mapping (BSGM) technologies combine high-resolution gastric myoelectrical activity measurements with symptom and psychological profiling to provide mechanistic insights into gastric motor and sensory dysfunction. An International Working Group convened to derive the first consensus classification of BSGM phenotypes (the "Auckland Classification"). METHODS: A Technical Group conducted a systematic literature and clinical database review to identify objective test biomarkers and candidate disease mechanisms. Evidence was synthesized across 50 studies (primarily in gastroparesis, chronic nausea and vomiting, and functional dyspepsia), and BSGM phenotypes were mapped to existing treatment guidelines. Subsequently, iterative review and development of consensus was performed by a Consensus Group composed of international clinical experts familiar with BSGM. Eleven statements underlying the classification were then derived and circulated as a final survey to establish agreement. RESULTS: Six BSGM phenotypes were endorsed: three defined by myoelectrical abnormalities (Dysrhythmic, High Frequency, and Low Meal Response) and three by characteristic symptom associations (Sensorimotor, Continuous, and Delayed Onset Symptoms). Published studies plausibly linked these phenotypes to mechanisms including interstitial cell of Cajal depletion, vagal impairment, hypomotility, visceral hypersensitivity, gut-brain dysregulation, and small bowel dysfunction. Phenotypes were also mapped to existing mechanism-based treatment guidelines. Ten out of the eleven statements had > 80% agreement. CONCLUSIONS: The Auckland Classification, derived by international consensus, presents a structured framework for BSGM-defined patient phenotypes. Evidence and mechanism-based treatment options are suggested for each phenotype to provide a foundation for research, further validation, and a pathway for integrating BSGM into clinical care.

Authors

Institutions

Publication Details

Journal
Neurogastroenterology & Motility
Published
2026-07-01
DOI
https://doi.org/10.1111/nmo.70377
Primary Topic
Gastrointestinal motility and disorders
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Expert Clinical Consensus on Body Surface Gastric Mapping Phenotypes for Gastroduodenal Disorders: ‘Auckland Classification’ v1.0

David Kunkel, William L. Hasler, Charles Verdonk, Timothy R. Angeli et al.
Neurogastroenterology & Motility
Gastrointestinal motility and disorders
article

Expert Clinical Consensus on Body Surface Gastric Mapping Phenotypes for Gastroduodenal Disorders: ‘Auckland Classification’ v1.0

David Kunkel, William L. Hasler, Charles Verdonk, Timothy R. Angeli, Homira Ayubi, I‐Hsuan Huang, Uday C. Ghoshal, Sahib S. Khalsa, Sanjay Pandanaboyana, Vincent Ho, Jonathan Sivakumar, Mohammad Bashashati, Leo K. Cheng, Nicha Wongjarupong, Jarongkorn Sirimongkolkasem, Nicholas R. Oblizajek, Leila Neshatian, William Xu, Sam Simmonds, Gabriel Schamberg, Amol Sharma, Anthony Hobson, Catherine Ngo, Armen A. Gharibans, Dániel Keszthelyi, Asma Fikree, Charlotte Daker, Xiao Jing Wang, Joy Liu, Bu Hayee, Chris Varghese, Shahin Ayazi, Daphne Foong, Nicky Dachs, Bianca W. Chang, Prateek Mathur, D. Levinthal, Thomas Abell, Douglas Weinstein, Abigail Stocker, Braden Kuo, Ali Rezaie, John Clarke, Mahesh Goenka, Alexander Podboy, Natasha Koloski, John Windsor, Mikaela Law, Sven Eriksson, Stefan Calder, Joseph Sujka, R Haidry, Linda Nguyen, Robert Bulat, Peng Du, Natalia Zarate‐Lopez, Jon Erickson, Greg O'Grady, Mark Fox, Christopher Brian Cederwall, Jan Tack, Gerald Holtman, Christopher N. Andrews, Henry P. Parkman, Irene Sonu, Mohammad Al‐Haddad, Baharak Moshiree
article en

Abstract

INTRODUCTION: Chronic gastroduodenal disorders remain challenging to manage, and new diagnostic approaches are needed to better delineate underlying causes and guide therapeutic decisions. Body Surface Gastric Mapping (BSGM) technologies combine high-resolution gastric myoelectrical activity measurements with symptom and psychological profiling to provide mechanistic insights into gastric motor and sensory dysfunction. An International Working Group convened to derive the first consensus classification of BSGM phenotypes (the "Auckland Classification"). METHODS: A Technical Group conducted a systematic literature and clinical database review to identify objective test biomarkers and candidate disease mechanisms. Evidence was synthesized across 50 studies (primarily in gastroparesis, chronic nausea and vomiting, and functional dyspepsia), and BSGM phenotypes were mapped to existing treatment guidelines. Subsequently, iterative review and development of consensus was performed by a Consensus Group composed of international clinical experts familiar with BSGM. Eleven statements underlying the classification were then derived and circulated as a final survey to establish agreement. RESULTS: Six BSGM phenotypes were endorsed: three defined by myoelectrical abnormalities (Dysrhythmic, High Frequency, and Low Meal Response) and three by characteristic symptom associations (Sensorimotor, Continuous, and Delayed Onset Symptoms). Published studies plausibly linked these phenotypes to mechanisms including interstitial cell of Cajal depletion, vagal impairment, hypomotility, visceral hypersensitivity, gut-brain dysregulation, and small bowel dysfunction. Phenotypes were also mapped to existing mechanism-based treatment guidelines. Ten out of the eleven statements had > 80% agreement. CONCLUSIONS: The Auckland Classification, derived by international consensus, presents a structured framework for BSGM-defined patient phenotypes. Evidence and mechanism-based treatment options are suggested for each phenotype to provide a foundation for research, further validation, and a pathway for integrating BSGM into clinical care.

Neurogastroenterology & MotilityVol. 38(7)
Northwestern University (US), Cedars-Sinai Medical Center (US), Hoag Memorial Hospital Presbyterian (US), Allegheny Health Network (US), Mayo Clinic (US), Auckland Institute of Studies (NZ), University of Louisville (US), Johns Hopkins University (US), Medical University of South Carolina (US), University of Auckland (NZ), Chulalongkorn University (TH), The University of Melbourne (AU), University of Calgary (CA), Washington and Lee University (US), University of Zurich (CH), University of South Florida (US), Wellington Hospital (NZ), London Clinic (GB), Apollo Gleneagles Hospitals (IN), Princess Alexandra Hospital (AU), Freeman Hospital (GB), Service de Santé des Armées (FR), Maastricht University (NL), University of California San Diego (US), Waitemata District Health Board (NZ), King's College Hospital NHS Foundation Trust (GB), Mayo Clinic in Arizona (US), University of Pittsburgh Medical Center (US), Cleveland Clinic London (GB), Chonburi Hospital (TH), Laureate Institute for Brain Research (US), Jersey Shore University Medical Center (US), Indiana University School of Medicine, University College London (GB), Wake Forest University (US), Indiana University – Purdue University Indianapolis (US), Western Sydney University (AU), National Defense Medical Center (TW), Columbia University (US), Temple University (US), The University of Texas at Austin (US), Stanford University (US)
University of Auckland, Health Research Council of New Zealand
Partnerships for the goals
Openalex Percentile: Top 6%
Gastrointestinal motility and disorders
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.