Physiologic data collected from wearable devices can detect inflammatory bowel disease (IBD) flares several weeks before symptom onset, underscoring the potential of wearable technology for IBD management to shift care from reactive treatment to proactive intervention.
Wearable devices — including smartwatches, fitness trackers, smart patches, and health-monitoring rings — can capture longitudinal data outside clinical settings. These tools may improve early detection of disease activity, reduce health care utilization through remote monitoring, and enhance patient engagement.
Early Digital Biomarkers of Disease Activity
Wearable technology is increasingly being used to monitor patients with IBD and to identify and predict flares and measure biomarkers. Future applications may expand to early disease detection, advanced data collection with ingestible devices, gut microbiome monitoring, and integration with machine learning.1 A prospective, exploratory, observational study from 2025 showed positive results for IBD flare detection in patients who used the Apple Watch (Apple), Fitbit (Google), and Oura Ring (Oura Health), which collected metrics for heart rate variability (HRV), heart rate (HR), resting heart rate (RHR), and daily steps.2 The study enrolled 309 patients with IBD from 36 states and found that the metrics collected from the wearable devices changed up to 7 weeks before inflammatory and symptomatic flare periods.2
Researchers identified inflammation as the main driver of the changes in physiologic metrics, with increases in HR and RHR and reductions in daily step counts observed during flare periods. Oxygen saturation was not different during inflammatory flares compared with inflammatory remission periods. The researchers concluded that their results demonstrate how digitally collected physiologic metrics can be a novel biomarker of disease activity.
For wearable devices to be truly effective, they must be easy to use and interpret.
Positioning Wearables Within Clinical Care
A recent systematic review evaluating wearable-based monitoring in IBD found that these technologies can enhance traditional symptom-based management when incorporated into a broader care framework. Devices in the review included heart monitors; ambulatory blood pressure monitors; accelerometers; wrist, arm, and body wearables with inertial gyroscopes; sleep monitors; sweat sensors; and an ostomy output sensor. Physiologic measurements included physical activity, blood pressure variability, arterial stiffness, sleep quality, heart rate variability, sweat cytokines, cardiac arrhythmia, inertial motion, and ostomy volume.
Overall, the meta-analysis concluded that wearable-based remote physiologic monitoring could supplement symptom-based IBD management, and effective remote patient monitoring programs in IBD should involve a multimodal approach combining mobile applications, telemedicine consultations, and wearable sensors.3 However, the authors noted that despite the potential for wearable devices in IBD monitoring, many published studies were limited by small sample sizes, weak associations with IBD outcomes, and low sensitivity and specificity of physiologic measures.3
Insights Into Sleep and Inflammation
Wearable devices have also provided objective data linking inflammation to altered sleep patterns.4 In a 2025 study, adults aged 18 years and older with IBD wore a device that collected information on sleep architecture, sleep efficiency, and total hours of sleep. The investigators found that active inflammation was associated with a significantly reduced percentage of sleep time in rapid eye movement (REM) and an increased percentage of sleep time in light sleep.4 Altered sleep architecture was evident only when inflammation was present and not with symptoms.4 Significant differences occurred for the rate that the percentage of time in deep and light sleep changed before and after inflammatory and symptomatic flares.
Wearable biosensors have been investigated for their ability in predicting postoperative length of stay in patients with IBD who had bowel surgery.5 The study found that a shorter sleep duration on postoperative day 4 or increased sleep efficiency on postoperative day 5 was associated with a reduced length of stay.5 In addition, a more positive change in sleep efficiency from postoperative day 4 to 5 was associated with a shorter length of stay.5 These findings suggest that sleep disruption may serve as a physiologic indicator of inflammatory activity, offering an additional, noninvasive monitoring parameter.
Noninvasive Biomarker Monitoring
Wearable devices also may provide a noninvasive approach for continuously tracking biomarkers associated with IBD. Investigators have reported positive results of a sweat-based wearable used for continuous monitoring of interleukin-1β and C-reactive protein in human eccrine sweat to track inflammation in patients with IBD and identify flare-ups.6 Another 2025 study using a wearable sensor device to measure C-reactive protein, interleukin-6, and calprotectin in patients with IBD found that perspiration may be an effective noninvasive method for continuously measuring inflammatory markers in IBD.7
Researchers have analyzed habitual physical activity in patients with IBD who wear a biaxial accelerometer armband (SenseWear; BodyMedia).8 They found an association between disease activity and quality of life in patients with IBD and a significant correlation between habitual physical activity levels and IBD activity, evidenced by significantly increased physical activity levels in remission compared with active disease.8
Studies have used artificial intelligence (AI) to study patient bowel sounds, which are associated with gastrointestinal motility and inflammation, as an alternative biomarker in IBD.9 AI-enabled high-definition auscultation can provide continuous monitoring of bowel sounds while using wearable or portable devices and allow assessment outside of clinical settings. Investigators found that AI models for bowel sound analysis showed high diagnostic performance in patients with IBD. In 1 example, a bright T-shirt with embedded microphones combined with a deep learning-based bowel sound event spotting algorithm and gradient boosting classifier achieved a mean area under the receiver operating characteristic curve of at least 0.83 for identifying patients with IBD from healthy control individuals.9 Smartphone-based convolutional neural network models also have shown solid performance in detecting bowel sounds.9
Patient Adoption and Feasibility
Patient acceptance of wearable technology is high. Patients with IBD have reported that wearable devices can be useful and are willing to wear them for routine management, according to results from a 2021 survey.10 Among 400 adults with IBD who completed the survey, 43% reported using wearable devices, 89% believed that wearable devices can provide important information about their health, and 94% reported that they would use a wearable device if it could help manage their IBD.10 Wrist-worn devices were their preferred device type.10
Although the technology of wearable devices in IBD management is promising, challenges include data accuracy, accessibility and adherence, compatibility with electronic health records, and privacy concerns. The modalities need further study before being fully integrated into clinical practice, according to researchers.
Overall, wearable devices provide a number of advantages in managing patients with IBD. The devices allow for continuous monitoring with real-time data that can help identify an impending flare as well as a dynamic view of a patient’s physiologic state.11 Continuous monitoring of patients with IBD may lead to earlier intervention, reducing the risk for severe flares and hospitalization.
“For wearable devices to be truly effective, they must be easy to use and interpret,” stated Dana J Lukin, MD, and colleagues in a 2025 editorial.11 “Clear, actionable data will be key to adoption and long-term success. By shifting IBD management from reactive to proactive, wearables have the potential to give patients a renewed sense of control over a disease that often feels unpredictable.”
