Wearable Technology and Remote Physiological Monitoring in Inflammatory Bowel Disease

Background and Aims: Remote patient monitoring (RPM) for inflammatory bowel disease (IBD) has historically focused on patient-reported symptoms and medication adherence through therapeutic monitoring. The advent of novel sensors and technology has made remote physiological monitoring an important area of innovation in care for IBD. This study will review current research on the use of wearable devices in physiological monitoring of IBD. Methods: We performed a systematic review of Scopus, Ovid, MEDLINE, and CENTRAL databases for articles that reported the use of wearable technology for physiological monitoring of patients with IBD through October 2024. Eligible articles were included development or evaluation of technologies to monitor IBD physiology. Articles that did not include IBD patients, did not include wearable devices, or did not evaluate remote patient monitoring (RPM) in IBD using wearable devices were excluded. Results: Six hundred seventeen unique abstracts were screened, with 59 studies meeting the inclusion criteria for full-text review, of which 20 articles were included. Patient characteristics across all studies included 1062 IBD patients, in addition to 290 healthy controls and 61 with other conditions. By number of patients, the most commonly studied physiological measurements included physical activity (n=704), blood pressure variability (n=328), arterial stiffness (n=210), sleep quality (n=203), heart rate variability (n=141), sweat cytokines (n=139), cardiac arrhythmia (n=72), inertial motion (n=72), and ostomy volume (n=9). The patient surveys indicated that wearables were generally acceptable, but noted barriers such as device cost, usability issues, and information overload. Conclusion: Wearable technologies show promise for remote physiological monitoring in IBD by providing continuous, objective data. These tools can complement traditional symptom-based monitoring and may enable earlier detection of flares.