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

肠道问题产生于各种各样的健康状况，导致生活质量下降，尴尬和大量的医疗资源使用。例如，超过20%的人患有便秘（Werth et al. 2019），约1.5%的人患有大便失禁（Perry et al., 2002）。肠道利益小组（2019）的便秘大成本报告强调，在英格兰，便秘在2017/18年度花费了NHS 1.62亿英镑，英国有超过650万人患有某种肠道问题。在这些领域，个人通常更喜欢通过技术解决方案来自我管理自己的状况。解决这个问题将使个人过上更积极的生活，并带来相应的社会和情感利益。我们的目标是通过谨慎的数字技术，赋予肠道疾病患者更大的自主权，活动和积极的生活方式。为了做到这一点，我们建议制造灵活的、可植入的传感器，附着在肠道软组织的表面，并在粪便在体内运动时跟踪其运动。我们将感知这些身体变化，并将数据传输到用户的接收器，以提供排便（失禁或便秘）的早期预警。这些数据还将为进一步的临床解释提供潜力，以确定他们身体行为的模式。技术工作将集中于传感器设备的创建，设计连接传感器的方法以及新型机械（压力）和声学传感。与临床医生和患者的实质性共同设计将用于指导传感器设计，并确保其具有翻译和使用的潜力。更广泛地说，这一领域很重要，因为肠道组织会随着不同的疾病发生重大变化，例如炎症性或退行性疾病（如克罗恩病、结肠炎、帕金森病）、创伤性损伤（如脊髓损伤）和化疗后。了解这个器官是如何随着时间和生活方式（饮食、压力、活动）而变化的，将为理解和管理这些疾病提供更大的窗口。更广泛地说，这个项目中的传感方法将为未来的器官监测建立一个平台。

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.