Digital Health: On-organ Sensing For Bowel Monitoring - A Bottom Up Approach

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Bowel issues arise from a wide range of health conditions, leading to a reduction in quality of life, embarrassment and substantial healthcare resource use. For example, constipation affects over 20% of the population (Werth et al 2019) and around 1.5% of the population suffer from faecal incontinence (Perry et al., 2002). The BIG Cost of Constipation report from the Bowel Interest group (2019) highlighted that in England constipation cost the NHS £162 million in 2017/18 and that over 6.5 million people in the UK have some sort of bowel problem. These are areas where individuals would generally prefer to self-manage their condition with a technological solution. Solving this would empower individuals to lead more active lives with corresponding social and emotional benefits.Our goal is to empower individuals with bowel conditions to have greater autonomy, activity and positive lifestyles, via discreet digital technologies. To do this, we propose creating flexible, implantable sensors that attach to the surface of the soft tissue of the bowel and track its motion as stool moves through the body. We will sense these physical changes and the data will be transmitted to a user's receiver to provide early warnings of bowel movements (for incontinence or constipation). The data will also provide potential for further clinical interpretation to identify patterns in their body's behaviour.Technical work will focus on the creation of the sensor device, devising methods for attaching the sensor and for novel mechanical (pressure) and acoustic sensing. Substantial codesign with clinicians and patients will be used to guide the sensor design and ensure it is usable with the potential for translation and take-up. More widely, this area is important because bowel tissue changes substantially with different diseases - for example, in inflammatory or degenerative diseases (e.g. Crohn's, Colitis, Parkinson's), trauma-induced injuries (e.g. spinal cord injury) and after chemotherapy. Being able to understand how this organ changes over time and with lifestyle (diet, stress, activity), will provide a greater window to understand and manage these conditions. More widely, the sensing approach in this project will establish a platform for future on-organ monitoring.