Inflammatory Bowel Disease (IBD) is a chronic gastrointestinal condition that affects millions of people around the world, primarily those under 35 years old. IBD consists of two primary diseases: Crohn’s Disease and Ulcerative Colitis. Symptoms of IBD vary individually but commonly include abdominal pain, diarrhea, and fatigue. People suffering from IBD often have negative impacts on their quality of life (QoL), given its interference with everyday activities. Monitoring the disease status of these patients has been invasive, primarily via blood draws and procedures like an endoscopy. While still in the early stages of research, examining patients’ data through heart rate variability and perspiration shows promise.

 Despite the availability of a range of treatments that can help manage the symptoms of IBD, there is no known cure for the disease. However, there may be hope for patients with the development of new wearables that can help patients better manage their symptoms and improve their overall quality of life.

 One of the latest breakthroughs in this field is sweat detection technology, which uses sensors to detect changes in a patient’s sweat, indicating when they may be experiencing a flare-up. In 2020, a University of Dallas study produced two ground-breaking findings that can apply to IBD and beyond. First, they analyzed “passive sweat” (meaning the patient does not have to participate in physical activity to produce the sweat) of 20 healthy volunteers. They discovered that biomarkers found that CRP (C-reactive protein), an indicator of inflammation, and interleukin-1β can be found in a person’s sweat. Additionally, they identified these two specific biomarkers for patients with IBD. 

The autonomic nervous system (ANS) is significant in maintaining homeostasis of the gastrointestinal tract; thus, physicians have begun exploring an indirect measure of the ANS in relation to IBD via heart rate variability (HRV).

Heart rate variability was consistently lower in patients experiencing a clinical flare-up than those in remission. Thus, some physicians are proponents of continuous heart rate monitoring as another possible means for early intervention of flare-ups. These findings prompted physicians from the Icahn School of Medicine at Mount Sinai to launch the IBD Forecast Study. 

Given not all patients with IBD experience the same symptoms or changes in sweat, which could limit the usefulness of this technology for some patients. Additionally, symptoms mimicking a flare-up could be related to other causes besides intestinal inflammation, such as irritable bowel syndrome (IBS) or food intolerance. Thus, deciphering between true and false positives could be complex for physicians. As far as measuring heart rate variability, “the associations between ANS function and inflammatory bowel disease (IBD) have been controversial and inconclusive in human studies”.  Physycians are also still determining the length of time necessary for patients to use the wearables and clinical timeline.

 Tracking IBD can be extensive, expensive, and invasive (i.e., frequent blood draws and procedures). Telemonitoring patients through wearables is a widely accepted approach to improving patient outcomes in the short term and reducing healthcare costs. By using preventative measures compared to simply reactive and non-curative treatments such as immunosuppressants alone, these devices can help patients better manage their symptoms and improve their overall quality of life.

Overall, sweat detection technology, along with measuring heart rate variability, are promising new tools for managing IBD. While the IBD Forecast study is still ongoing, physicians are hopeful that machine learning can begin predicting algorithms with more excellent acuity in IBD. Despite limitations to this technology, it has the potential to improve the lives of millions of people living with IBD.