P0712 Feasibility of a smart toilet seat for the measurement of physiological parameters in active Ulcerative Colitis: A pilot study.

Abstract

Background Management of inflammatory bowel disease (IBD) remains largely reactive, with limited ability to predict or prevent flares. Passive remote monitoring of physiological parameters could provide objective data on IBD activity and facilitate the development of algorithms for early flare detection. OnePlanet Research Center has developed the smart toilet seat, a novel device that noninvasively measures several physiological parameters during a toilet visit (Figure 1). In this study, we aimed to 1) evaluate feasibility of using the smart toilet seat for home monitoring for ulcerative colitis (UC) 2) measure physiological parameters in UC patients starting new medical treatment during a flare using the smart toilet seat.

Methods We installed the smart toilet seat at the homes of eight patients with active UC starting new treatment for a period of 8 weeks. Patients were instructed to use the smart toilet seat as they would use their regular toilet, and indicate their toilet visit and stool consistency using remote control buttons. Measurements included number of toilet visits, toilet visit duration, stool consistency, heart rate and perianal temperature. Disease activity was measured weekly using an app-based self-reported Simple Clinical Colitis Activity Index (SCCAI) and faecal calprotectin (FC) (CalproSmart Self Test).

Results 33 patients were contacted for participation, of which eight patients with active UC were included (24%). Next to maintenance therapy with aminosalicylates, patient started with various types of treatment (Table 1). Median FC was 1107 µg/g (range <77 – >1500 µg/g (lower and upper levels of detection)) at week 1 and below the lower limit of detection (<77 µg/g (<77 – >1500 µg/g)) at week 8. 1431 visits to the Smart toilet seat were recorded, of which 326 were defaecation visits. Median toilet visit duration for all visits and defaecation visits was respectively 1.8 and 4.2 minutes. Between week 1 and week 8, a median change of -6 (range -19, 4) in weekly bowel frequency was measured by the Smart toilet seat and median change in weekly SCCAI was -2 (range -4.5, -0.5) (R2 = 0.75). All participants indicated they would use the Smart toilet seat in the future if it would give their gastroenterologist or general physician more insight into their disease.

Conclusion Our study shows it was feasible to measure stool frequency and multiple physiological parameters using a smart toilet seat in a population of UC. Future research is aimed to identify relevant parameters measured by the smart toilet seat that are related to the development of IBD flares, which could serve as basis for predictive models.