# Smart Toilet with Artificial Intelligence for Remote Management of Inflammatory Bowel Disease

> **NIH NIH R41** · COPRATA, INC. · 2022 · $349,877

## Abstract

ABSTRACT
Inflammatory Bowel Disease (IBD) affects three million US adults and, due to chronicity, requires
lifelong medical care, negatively impacts patient quality of life, and results in large healthcare
costs. The disease course is characterized by remissions and flare-ups, thus disease
management by medication and dietary interventions requires frequent monitoring. Less invasive
than endoscopy, longitudinal tracking of the fecal biomarker calprotectin is increasingly used to
achieve and maintain remission. Remote disease management through app-based diaries of
bowel movements to assess disease activity and at-home measurement of calprotectin have been
found effective when implemented consistently; however, patient adherence is as low as 30%.
We propose a technology that enables automatic and seamless monitoring of bowel movements
and calprotectin, thereby greatly increasing patient adherence to tracking regimens. The
innovation is a Smart Sampling Toilet system: an engineered portal retrofitted to a conventional
toilet that, discreetly and post-flush, inspects stool appearance and enables hands-free stool
sampling for analysis. The system has been demonstrated in the laboratory with human stool
specimens across the range of stool forms, including loose stools. An artificial intelligence (AI)
method has been developed for stool image analysis and classification.
The objective of this study is to demonstrate feasibility of onsite measurement of calprotectin by
the Smart Sampling Toilet, a prototype system for use by human subjects that integrates stool
morphology analysis. Specific Aim 1 is a benchtop study using commercial lateral flow assays to
assess sensitivity and specificity of calprotectin measurements from stool sampled through the
engineered portal. After a spiking study, we will measure calprotectin on clinical specimens from
patients with IBD through a collaboration with the Duke University Gastroenterology IBD Clinic.
In Specific Aim 2, we will deploy a Smart Toilet prototype outside of the laboratory for use by
human subjects to refine the AI algorithm for stool morphology classification. We will evaluate
specimens both from healthy subjects using the toilet and from flushing clinical specimens
obtained from IBD patients.
The data obtained in this study will be the basis for a Phase 2 study with the Smart Toilet system
installed for use by patients through the Duke IBD clinic. Ultimately, we envision Smart Toilet
systems installed in the home to benefit IBD disease management and improve patient quality of
life by removing barriers to stool-data access and enabling improved clinical outcomes.

## Key facts

- **NIH application ID:** 10482219
- **Project number:** 1R41DK131678-01A1
- **Recipient organization:** COPRATA, INC.
- **Principal Investigator:** Sonia Grego
- **Activity code:** R41 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $349,877
- **Award type:** 1
- **Project period:** 2022-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10482219

## Citation

> US National Institutes of Health, RePORTER application 10482219, Smart Toilet with Artificial Intelligence for Remote Management of Inflammatory Bowel Disease (1R41DK131678-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10482219. Licensed CC0.

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