Wrist-worn devices could give advance notice of when the wearer might experience an IBD flare.
- For
people with the unpredictable conditions falling under the inflammatory
bowel disease (IBD) umbrella, an early warning system for flares may one
day be available in the wearable device on the wrist.
- A
new study from researchers at Mount Sinai reports that such devices can
predict imminent inflammatory and symptomatic IBD flares as far in advance
as 7 weeks.
- With
such advance notice, it will be possible for people with IBD and their
physicians to adjust medications to blunt the upcoming flares before it
arrives.
- The
wearables already track physiological indicators such as heart rate, heart
rate variability, steps, and pulse oximetry that exhibit significant
changes far in advance of IBD flare-ups.
Wearable devices could provide an unprecedented 7
weeks’ advance warning of an inflammatory bowel disease (IBD) flare,
according to a new study published by researchers at the Icahn School of
Medicine at Mount Sinai in New York City.
The study
finds that significant changes in physiological metrics tracked by three
popular wearable devices, Apple Watch, Fitbit, and the Oura Ring, occurred in
the weeks preceding an IBD flare.
The findings appear in the journal Gastroenterology.
What are the
signs of an IBD flare?
As many as
IBD tends not to be continually active, and people who
have it may go for extended periods without experiencing a flare-up of the
symptoms that typically arrives without warning.
In the early stages of a flare, a physician may seek
confirmation with a blood test and stool analysis, but at that point, the event
is already underway. There is a need to better predict flares before they
happen.
The Mount Sinai researchers identified signals in the
body that turned out to be associated with an imminent flare-up of IBD
symptoms:
- longitudinal heart
rate — heart rate changes over time
- resting heart rate — a
person’s heart rate when resting
- heart rate variability
— the amount of variation in time between heartbeats, or their regularity
- steps — an indicator
or physical activity
- oxygenation — or pulse
ox, the amount of oxygen blood hemoglobin is carrying.
Significantly,
all of these indicators exhibited changes from baseline values up to 7 weeks
before any indication of inflammation or IBD symptoms.
For the study, the authors recruited 309 adults from
across the United States. All participants had a diagnosis of either Crohn’s
disease or ulcerative colitis, and were taking medication for IBD.
Participants were expected to wear their devices 8
hours a day and respond to questionnaires a minimum of four times a week. The
study began in December 2021 and ran until June 2023, with individuals
remaining involved for as long as they wished.
IBD flares
are often unpredictable
Rudolph Bedford, MD, a board0certified gastroenterologist at
Providence Saint John’s Health Center in Santa Monica, CA, who was not involved
in the study, described the uncertainty of living with IBD to Medical News Today.
There is currently no way to predict when symptoms
might flare up, he said, “unless you happen to get a blood test or a stool
sample just before that flare occurs, but not really.”
“Patients really don’t sense it until the flare is
upon them. They may have some abdominal disturbances before they actually have
a flare, but that’s usually immediately just before it is about to occur,”
Bedford told us.
Having advance warning could empower people with IBD
to get ahead of symptoms.
“They may be able to take some changes in what they’re
doing before that occurs, whether that’s an adjustment of medication or an
adjustment of diet,” said Bedford. “Maybe even getting a preemptory lab test,
which again will affirm that a flare is about to occur.”
How to
prevent IBD flares
Bedford said that
“things that may cause IBD to flare up would be stress, smoking, and also
taking non-steroidal anti-inflammatory drugs, things like ibuprofen, Motrin,
and aspirin.”
“There are not too many foods,” he continued, “that
will flare up IBD, but for certain individuals that might be the case.”
He
suggested people avoid “any foods that might exacerbate somebody’s disease that
they know of, or have an inkling they should just stay away from. It can be
very individualized from personal to person in terms of what exacerbates the
disease.”
Bedford also cited eating plans along the lines of the
Mediterranean diet as being good choices for people with IBD.
Wearable
devices could help predict IBD flares
The current study’s
first author is Robert Hirten, MD,
Clinical Director of the Hasso Plattner Institute for Digital Health and Associate
Professor of Medicine (Gastroenterology), and Artificial Intelligence and Human
Health at the Icahn School of Medicine at Mount Sinai.
Speaking to MNT,
he described the study as an encouraging first step:
“We find that metrics that
relate to physiological activity collected from wearables are able to
differentiate whether inflammation is present in the body. These types of
changes, however, are likely not specific to one disease. Rather, they reflect
and are altered by inflammation in the body. Therefore, our findings will
likely be useful in the setting of chronic inflammatory diseases, and may help
with the identification of inflammation developing from these conditions.”
“Our group is exploring similar approaches in other
chronic inflammatory conditions, such as rheumatoid arthritis,” Hirten
reported.
He also noted that he is not aware of any similar
research being undertaken by wearable manufacturers.
“Our goal is to develop deep learning algorithms (AI
algorithms) that pick up these changes in wearable measured signatures that we
have described, and determine the probability or chance that a person will
flare,” added Hirten.
“This will enable the creation of an individualized
warning system that a person’s inflammatory bowel disease may be worsening or
flaring,” he suggested.
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