Giant leaps are happening when it comes to managing and treating Crohn’s disease and ulcerative colitis. As someone who was diagnosed with Crohn’s in 2005, I’m amazed and comforted by all the promising research and advances that support patients and improve our experience of living with inflammatory bowel disease (IBD). Whether it’s a wearable device, a state-of-the-art toilet sensor, a hyperbaric oxygen chamber, or a bioadhesive sticker — new diagnostic techniques and treatment tools enable patients to gain back some control of their health.
Below are my top picks for technologies that are currently on the market and some that are in the works.
4 Technologies Available Now
1. Intestinal Ultrasound to Monitor Disease Activity
It goes without saying that going through colonoscopies, CT (computerized tomography) scans, and MREs (magnetic resonance imaging) is extremely taxing on IBD patients. As noted by GI and Hepatology News, intestinal ultrasound is easing the burden of managing and treating IBD by serving as an excellent tool to help clinicians assess disease activity and highlight complications. It is refreshing to know that I don’t need to drink a disgusting concoction, or get poked and prodded with needles, while getting radiation. Right now, hundreds of gastroenterologists around the world are being trained and sharing their intel to make this common practice in IBD care now and into the future in the United States. Intestinal ultrasound is a huge patient win for everyone involved. Within 15 minutes, a noninvasive ultrasound performed right at the appointment (similar to pregnancy ultrasounds), provides a detailed, live look at the small bowel and colon. In that moment, GI’s are able to see whether treatment is working, what’s going on in the intestines in real time, and know right then and there if there’s active disease or other complications.
2. Oxygen Chambers Aid Fistulizing Disease
A study presented at the 2023 Crohn’s and Colitis Congress in Denver explored how hyperbaric oxygen chambers could help IBD patients, according to Healio. Hyperbaric oxygen therapy (HBOT) delivers 100 percent oxygen in a pressurized chamber, which increases tissue oxygen levels and helps to regulate inflammatory pathways. The study looked at the potential clinical benefit of HBOT in fistulizing Crohn’s disease.
Amr Dokmak, MD, and his colleagues included 16 studies in their analysis, consisting of 164 patients who underwent 5,125 hyperbaric oxygen therapy sessions. Researchers specified clinical remission as closure of fistula and complete cessation of drainage, and partial response as improvement in fistula drainage. The review showed an 87 percent clinical response rate, suggesting that HBOT may be a safe and effective complementary therapy in conjunction with biologics for patients dealing with refractory disease. It’s important to know rectovaginal fistulas were the least responsive to this type of therapy.
By having a conversation with your care team, you can determine if you’re a candidate for this treatment option. Most insurances require a prior authorization to cover HBOT treatments, so your out-of-pocket cost will depend on your insurance plan.
3. Artificial Intelligence and IBD Nutrition
Another exciting development out of the 2023 Crohn’s and Colitis Congress was the utilization of artificial intelligence (AI) and precision nutrition, per the Crohn's and Colitis Foundation. While diet impacts each person uniquely, the AI models can predict which diet works best for each person. The models can also create optimal diets based on a person’s health history. Discovering trigger foods and knowing what a “safe” food or drink is can be incredibly time consuming and exhausting as a patient — this takes a lot of the guesswork and energy out of the process and allows patients to make modifications to set them up for feeling better and helping to keep symptoms at bay.
4. Blood Tests Predicts the Course of IBD
Thanks to the Crohn’s and Colitis Foundation, a U.S.-based trial called PRECIOUS is testing the ability of a blood test to determine the severity of disease. The blood test is called “PredictSURE IBD” and can determine whether your IBD will be mild or aggressive. The trial is actively enrolling participants. To participate, a patient must provide up to 3 blood samples for biomarker analysis. The initial follow up is for 12 months, but patients can consent for up to three years. If PRECIOUS is successful, it will not only drive treatment decisions, but be the first step towards personalized medicine for IBD in the United States.
5 Technologies in the Works
1. Outsense Eliminates Stool Handling
Outsense is transforming human waste into lifesaving medical insights, by analyzing and diagnosing stools within the toilet bowl! This is a huge win for patients, as handling stool samples is not a fun or easy task.
A small device clips onto a toilet bowl and has a smart optimal sensor that scans human waste (both urine and stool) without the need for any user intervention. The information gathered is then transferred to a secure cloud platform where it is analyzed using artificial intelligence (AI) tools. The system’s report is then delivered to the caregiver or the patient and can be shared directly to medical professionals. The information gathered also becomes part of the Outsense optical virtual database (anonymously) that plays a critical role in precision medicine and understanding the nature of human physiology.
2. SmartWatch Apps to Monitor Disease
Smart watch apps can do a lot more than counting your steps. Now they may be able to help pinpoint and predict an IBD flare. MedPage Today reported on a poster presentation at the Crohn’s and Colitis Congress in January 2023 by Robert Hirten, MD, of the Icahn School of Medicine–Susan and Leonard Feinstein Inflammatory Bowel Disease Center at Mt. Sinai School of Medicine in New York City, which looked at how a watch application could show inflammatory markers based on sweat and heart rate variability. According to the study, when a person with IBD has a normal gut environment, there’s a bell curve produced on the app. If the curve flattens, it could be a sign of a flare.
Dr. Hirten said that in the future by adding this app to devices such as the Apple Watch, patients can keep a close eye on tracking possible health changes that may have previously gone under the radar. According to Healio, more research is expected in the next year before this is used in clinical settings. While this concept is in the early stages, it’s exciting and will allow patients to be involved in monitoring their disease outside of a medical setting and be given the chance to intervene before a flare spirals out of control. Life gets so busy and juggling a chronic illness when my “sense of normal” is not that of the population, can make it easy to ignore how my body is speaking to me through symptoms. By having this involuntary intel, that doesn’t require me to do anything extra as a patient, I’m all about it!
3. Biomarkers in Sweat Can Determine Flares
University of Texas at Dallas researchers also created a wearable device that monitors sweat for biomarkers that could single IBD flares. The device looks like a wristwatch, and in a “proof-of-concept study funded by the Crohn’s and Colitis Foundation and published in the Foundation’s journal, Inflammatory Bowel Diseases, it was determined that interleukin-1-beta and C-reactive protein (CRP) is present in human sweat. Interleukin-1-beta is a protein that’s an important mediator of inflammation and tissue damage in IBD. CRP is a protein that your liver makes. High CRP levels may indicate a serious health condition that causes inflammation. When IBD is flaring, an elevated CRP can show inflammation is present in the body, as a way to help tissues heal from injury, infection, or disease.
This is the first study to show that the two biomarkers can be detected in sweat. This could provide a warning for patients and make IBD less unpredictable.
While it doesn’t necessarily indicate there’s a flare going on, these markers indicate what could soon be on the horizon and help doctors understand sooner whether treatment is working. Testing is still going on before this technology is available to patients.
4. Stickers and Patches to Monitor Organ Activity
Bioadhesives, or stickers, are also making headlines, as reported in Scientific American. You can think of it as a stick-on ultrasound patch, the size of a postage stamp, that can record activity of organs for 48 hours at a time. It will still be years before this hits the market, but the prototype is being tweaked and finalized and could change how closely and how often we’re able to monitor our health. Rather than a snapshot in a moment of time, an adhesive has the opportunity to take a long-term continuous look at organ activity.
5. Stem Cell Therapy
Due to the cost and side effects associated with biologic medications, there’s growing interest in the development of stem cell therapy. Per Mayo Clinic, perianal fistula is a complicated manifestation of IBD that can be difficult to treat. Researchers at Mayo Clinic recently studied the use of a dissolvable plug loaded with stem cells from a patient’s own fat tissue to help with single tract perianal fistulas, according to MedicalXpress. In the study that involved 20 patients, a bioabsorbable plug was implanted close to the anal fistula tract and they were followed for one year. Of the patients involved in the study, 14 saw complete healing after six month, and 13 patients did at one year. Three of the patient participants withdrew during the clinical trial. Researchers plan on further studying the use of a stem cell-coated fistula plug with a larger sample size and different types of fistulas. If the results continue to be this positive, the procedure could be part of routine clinical care in the next two to three years.
James Lewis, MD, and Louis Cohen, MD, are looking at autologous stem cell transplant, which essentially shuts down an IBD patient’s immune system with the hopes of resetting the immune system and making it healthy and functional, notes the Crohn's and Colitis Foundation. This treatment would be geared for Crohn’s patients who are not responding to existing biologic therapies. This is an extreme measure and requires a person to stay in the hospital for several weeks of isolation.
So Much on the Horizon, So Much to Be Excited About
These advancements make me feel hopeful for what lies ahead in the treatment and management of IBD. When I was first diagnosed with Crohn’s, I never dreamed there would be so much meaningful change in this disease space. Patients now can sit as copilot with their care provider, rather than in the back seat. By actively being a citizen scientist, we can feel more educated about our patient journey and limit the blindsiding flares and the challenging, unpredictable nature that is life with IBD.
Important: The views and opinions expressed in this article are those of the author and not Everyday Health.