Analyzing urine and stool to get a picture of health has traditionally been the work of dedicated diagnostic labs. People submit samples and technicians analyze them for a range of factors, from the presence of blood or harmful pathogens that may be causing disease to the concentration of certain chemicals that are supposed to be filtered out of the body.

Now, scientists have developed a way to bring some of that process into the home with a smart toilet that could someday detect a range of disease markers in stool and urine, including for colorectal and urologic cancer. In a paper recently published in Nature Biomedical Engineering, scientists at Stanford University reveal the smart toilet could allow for continuous health monitoring of human urine and stool and report findings from a small survey of test users on their comfort level with the device.

The smart toilet is an ordinary model equipped with a range of visible tools, such as an anus camera and urinalysis strip, fitted inside the bowl. With the help of motion detectors and pressure sensors, the tools deploy a range of tests that can determine the health of excreta. Urine samples, for instance, will undergo molecular analysis to check for a number of biomarkers, which includes protein, nitrite, and leukocytes important to detect kidney function and diagnose urinary tract infections. Stool will be assessed on its physical characteristics, such as color and consistency, which can help diagnose gastrointestinal disorders, infections, and cancers.

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Data from the smart toilet could be phenomenal for understanding health and monitoring the spread of a viral disease, including Covid-19, according to Jack Gilbert, a microbiologist at the Scripps Institution of Oceanography at the University of California in San Diego, who was not involved in the research.

If we could collect data from the general population in a controlled clinical trial, its possible that you could use the existing platform to look for changes in urine or stool consistency associated with Covid-19, said Gilbert.

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The toilets flush lever has a built-in identification system that reads fingerprints and allows for it to discern between users. The feedback is automatically captured by a camera, in the form of pictures and short videos, and sent to what the researchers behind the machine say is a secure, cloud-based health portal that can be easily accessed by the user at any point in the future.

Seung-min Park, lead author of the study and a molecular imaging scientist at Stanford University, likened the smart toilet to a smartwatch: It allows for continuous health monitoring and could be incorporated into ones daily routine with minimal human intervention. He also shared that the team has been working closely with physicians to ensure that data from the toilet can still be useful for the medical community.

We have developed the toilet with the help of urologists and colorectal surgeons, and prioritized their feedback to make sure it is as close to clinical use as it can be, said Park.

In the study, Park and his colleagues collected urine and stool samples from 300 smart toilet users within the Stanford community. The toilet was installed in a gender-neutral bathroom next to the their laboratory, and volunteers were asked to use the toilet as they would any other facility. Only Park and colleagues immediately involved in the research had access to the data.

The study volunteers were surveyed to assess whether they would be comfortable with using such a toilet on a daily basis. About 37% said they were somewhat comfortable, while 15% expressed feeling very comfortable. However, 30% of the participants felt uncomfortable using the toilet, which Park said was primarily because of the toilets anal camera.

The researchers have packaged a bunch of ideas together in a unified format, said Kevin Honaker, chief executive officer at microbiome data collection and analysis firm BiomeSense, who wasnt involved in the research. And it is all in one system, which Ive never really seen before. Despite this novelty, and given that only a minority of those surveyed were comfortable with the device, Honaker said that privacy and practicality are important concerns when it comes to technologies like smart toilets.

Scientists and researchers would think that this is a great idea [to have an anal camera], but in my experience, the privacy concerns are catastrophically high and youre going to have incredible patient resistance, said Honaker.

Another hurdle is maintenance: With its external components and tools, such as waterproof cameras, it is imperative that the toilet is robustly cleaned with regular bathroom cleaners after every use a considerable task even for users who live alone.

The biggest challenge before the smart toilet can be in routine use, however, is that there arent yet data on how well the toilet can actually monitor for disease in real time. During the study period, while the toilet analyzed samples from the 300 volunteers, Park and his colleagues also collected samples after every visit and sent them to a laboratory. The results of this comparative analysis which only checked for volume of urine, and color and consistency of stool and compared it to the feedback given by the toilet havent been published, but Park said the results from traditional lab testing and those from the toilet were similar.

Given this lack of data, it remains to be seen whether the smart toilet can become anywhere near as ubiquitous as smartwatches. Park and his colleagues are currently focused on fine-tuning the capabilities of the toilet before they go on to validating its diagnostic tools. One future aspiration: individualizing some of the tests in the toilet based on the health conditions of its users, such as monitoring glucose in urine in a person with diabetes and testing for urinary tract infections.

But the short-term goal is ensuring usability, and Park said he is confident that this can be achieved.

Throughout the process of developing this toilet, we have tried to ensure that it does not interfere with any normal human behavior because everyone has to go to the bathroom, he said.

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'Smart toilet' could monitor for signs of illness in urine and stool, study finds - STAT