Poop-Tracking App Proves More Accurate Than Evaluating Stool Samples

New research shows that a specialized app is just as effective as gastroenterologists at characterizing poop.

To come to this conclusion, researchers asked 14 patients with diarrhea-predominant irritable bowel syndrome (IBS-D) to capture images of their poop for two weeks using the app.

After two gastroenterologists analyzed the app data for sensitivity, specificity, and accuracy, they determined that the app was able to give more accurate and complete descriptions of constipation, diarrhea, and other forms of poop than a patient could.

Wondering why this is necessary in the first place? The researchers wanted to have an effective way of monitoring poop to see how well medication was working for patients with IBS-D, lead study author Mark Pimentel, MD, a gastroenterologist and executive director of the Medically Associated Science and Technology Program at Cedars-Sinai, told Verywell.

“If I gave a patient a drug for constipation and all of the sudden they’re having watery diarrhea, that would alert the patient—and me—to change things,” he explained. “But they may not understand what ‘watery diarrhea’ is.”

The app was created by Dieta Health, a graduate of the Cedars-Sinai Accelerator program that helps entrepreneurs bring their healthcare technology products to the market.

How Does the App Work?

The way the app works is simple: Patients simply use the bathroom and take a picture of what’s in the toilet bowel before they add toilet paper, Pimentel said.

“The app calculates the degree of constipation or diarrhea, the volume of stool, and other elements,” Pimentel said.

Using artificial intelligence (AI), the app analyzes images for visual characteristics including consistency, fragmentation, edge fuzziness, and volume. The subjects were also asked to report specifics on their poop to researchers.

“Trained AI was superior to subject self-reporting of Bristol Stool Scale,” the researchers wrote in their conclusion, comparing the app to a commonly-used method of classifying poop. “AI assessments could provide more objective outcome measures for stool characterization in gastroenterology.”

Pimentel said new features will eventually be added to the app, including recognition of blood in the poop.

How Doctors Currently Track Poop In Patients

The current method for tracking bowel movements in patients isn’t perfect, Pimentel said.

“It’s basically just asking questions: ‘Are you having diarrhea? How many times a day?’” he said. “There aren’t any specifics more than that.”

The simplest way of having patients track their poop is through a stool diary, Ellen Stein, MD, a gastroenterologist and associate professor at Rutgers Robert Wood Johnson Medical School, told Verywell.

“The patient receives some information about the Bristol Stool Scale and is asked to report frequency and consistency of stool,” she said. “Pen and paper works for some folks where they list the days of the week and describe their stool.”

But Pimentel said that having patients use the Bristol Stool Scale can be inaccurate.

“Patients don’t always understand the cartoon drawings and translating that into real life,” he said.

Using an app “can potentially help a patient simply track their bowel movements better in order to provide more accurate data to their physician,” Randy Meisner, MD, a gastroenterologist at Spectrum Health, told Verywell. “It is simply going to be more accurate than to try to recall at your doctor visit.”

When to Reach Out to a Doctor About Your Poop If You’re on Medication

There’s a range of what is considered normal for pooping.

“A normal amount of stool is anywhere from three bowel movements a day to three bowel movements a week,” Meisner said. “Certainly, people will vary from this amount.”

In general, you’ll want to call your doctor if you notice blood in your poop, Stein said.

“A big change in bowel habits is also a reason to speak with your physician,” she said. “If you have one or two off days from your usual pattern, that can be OK, but if suddenly you change from going every day once a day with formed stool to having four to six times a day fatty, floating stool, an evaluation should be performed.”

Pimentel is hopeful that the app will eventually become more widely used.

“It offers better communication with the doctor but, for research purposes and FDA approval of drugs, this is really important,” he said. “The big challenge with medications is that we’re relying on patients telling us during a trial what their stool situation is. But we found during this study that patients weren’t getting it right or were sporadic in understanding what the stool is supposed to look like. The app doesn’t lie.”