In the last couple of decades, there have been technological advances in gastroenterology. These include advances in endoscopic procedures, innovative therapeutics such as biologic medicines, and an improved understanding of the gut microbiome, among many others. The microbiome includes all the bacteria and microorganisms that live in the intestines. This is necessary for healthy digestion.
Today’s health care providers conduct a 15-to-30-minute clinic visit spaced out every few months. Having such few meetings between patients and healthcare providers can make it difficult for ideal communication. Regular communication helps to exchange information efficiently and effectively, to help improve treatment and illness outcomes. This is especially true for those with chronic conditions such as functional gastrointestinal disorders (FGIDs). FGID’s include irritable bowel syndrome (IBS), dyspepsia, and chronic constipation.
Mobile Apps for Digestive Health
These conditions can be difficult to treat, and it is important to come up with new ways for patients and healthcare providers to communicate. As of 2019, 81% of Americans have a smartphone. As a result, there has been an explosion in the number of mobile health apps. These apps can have several purposes such as education and allowing users to record their symptoms. Some apps also allow for patients and their healthcare providers to easily communicate with each other.
• MyGiHealth® – To support people with FGIDs and chronic gastrointestinal (GI) symptoms, our research groups at Cedars-Sinai Medical Center and the University of Michigan developed an app called MyGiHealth®. It allows users to track their GI symptoms and quality of life. This app also provides personalized education and information about treatments for common FGIDs. The app also has a GI symptom history survey that creates a report based on your responses. On average, 4 in 10 people are affected by functional gastrointestinal and motility disorders (FGIDs).
• GIThrive® – Another example of a digital platform designed for those with chronic GI conditions is GIThrive®. This is an employer-sponsored digestive health program by Vivante Health. The platform has several features including GI symptom and mental health monitoring, behavioral therapy, and one-on-one sessions with dietitians and health coaches. Ultimately, the goal of GIThrive® is to improve digestive disease outcomes while at the same time reducing healthcare costs.
Aside from smartphone-based symptom trackers, there has been an increase in the availability of digital therapies for patients with FGIDs. To support those with IBS, Zemedy® by Bold Health and Parallel™ by Mahana Therapeutics created apps that provide personalized feedback and skills training in cognitive behavioral therapy (CBT)—a form of psychological treatment. While traditional in-person CBT is effective in treating IBS symptoms, access to it is currently limited to a few, large academic medical centers. By providing structured CBT digitally using smartphone apps, Zemedy® and Parallel™ aim to increase access to this effective therapy on a wide scale. One large randomized controlled trial showed positive results of CBT treatments provided through Parallel™. This study found that CBT improved IBS symptoms at the 1-year mark of using Parallel™ when compared to usual treatment. It was authorized by the U.S. Food and Drug Administration (FDA) in November 2020.
The most well-known wearable biosensors are fitness trackers that monitor step counts, heart rate, and sleep, among other health-related measurements. In addition to easily accessible devices, research has been done to improve biosensor use in patient care. There are now devices in development that passively monitor the GI system. For example, our research group helped develop a device called AbStats.® This device has been cleared by the U.S. FDA to be used by healthcare providers in hospitals and other healthcare settings for non-invasive, real-time recording of the digestive system. It uses a low-profile microphone that sticks to the abdominal wall to measure the number of times the intestines contract within a certain period. This measurement is also referred to as intestinal rate. In an early study, we found that AbStats® can recognize small, low-calorie meals from large, high-calorie meals in healthy people. While more studies are needed, the device may prove useful in monitoring diet and responses to medications or dietary treatments in those with FGIDs.
Another new technology is devices that are swallowed and monitor internal body functions. These devices can
also provide a treatment. As an example, early studies in people with chronic constipation found that a vibrating capsule increased the number of bowel movements. Larger trials are ongoing to further prove the safety and value of this device.
Another promising digital therapy for those with FGIDs is virtual reality (VR). Recent new technologies have allowed VR headsets to become cheaper, more portable, and more accessible. Recent trials have shown that it reduces pain among hospitalized patients and pregnant, laboring women. VR may also be useful for treating chronic belly pain among those with IBS and dyspepsia. This use of VR has ongoing research to formally study the impact.
Learn more about VR by viewing IFFGDs Podcast: Virtual Reality in Healthcare with Dr. Brennan Spiegel.
Going forward, exciting new technologies will continue to become available for patients with FGIDs. As they are being developed, researchers should rigorously test these new devices and platforms. Well-designed research studies will be done to show their value and safety. Only then will these innovative technologies be widely used by patients and their healthcare providers. This, in turn, will dramatically change how we deliver care for patients with FGIDs and hopefully improve their outcomes and quality of life
This article was adapted from IFFGD Publication #278- New and Emerging Digital Health Technologies written by Christopher V. Almario, MD, MSHPM, FACG; Cedars-Sinai Medical Center; Karsh Division of Gastroenterology and Hepatology; Cedars-Sinai Center for Outcomes Research and Education (CS-CORE)