Getting beyond the gut: AI tool reveals hidden health risks for people with inflammatory bowel disease

University of Alberta researchers have created a new tool to help doctors and patients recognize other illnesses commonly associated with inflammatory bowel disease (IBD), including autoimmune, mental health and heart problems. 

The team used artificial intelligence to analyze de-identified medical records for 30,334 Albertans living with inflammatory bowel disease over a 20-year period, recently publishing their findings in a Nature Portfolio publication.

They report that 57 per cent of patients have at least one other associated autoimmune disorder or manifestation of disease beyond the gut. Mental and musculoskeletal disorders are the most common, but they also found elevated incidences of dermatological and respiratory conditions, disorders of the genitals and urinary system, and cardiovascular disease. 

Using a new approach known as “network medicine,” the team created interactive tools to visualize the occurrence, frequency, sequence and clustering of the associated disorders as an aid for diagnosing and treating conditions that may otherwise be overlooked.

“The takeaway for the patient is that while they may be seeing a gastroenterologist with expertise in inflammatory bowel disease because they experience diarrhea, rectal bleeding or abdominal pain, it may turn out that they actually have several other conditions as well,” says principal investigator Daniel C. Baumgart, professor of medicine and adjunct professor of computing science. 

“Physicians will want to ensure that patients are managed by a multidisciplinary team, and the tools help to find out which other conditions to actively screen for,” says Baumgart, who is also principal investigator and program director of From Data to Decision, an international research consortium using artificial intelligence applications across various sectors including health care.

Inflammatory bowel disease is a group of conditions that inflame the lining of the gastrointestinal tract. Canada has one of the highest rates of IBD in the world, with it affecting 322,600 Canadians in 2023, according to Crohn’s and Colitis Canada. Symptoms may include abdominal cramping, weight loss and low appetite. 

The research team found large groups of patients who also experienced anxiety, depression and chronic pain. 

“While we have been aware of skin and musculoskeletal inflammation, including the associated pain conditions, we have not really paid enough attention to mental health,” Baumgart says. “This is very important because it affects people’s quality of life, their ability to work, their social life.”

The culprit, says Baumgart, is systemic inflammation, which affects not only the gut, but also the brain, the vascular system and other bodily functions.

“A lot of people — including doctors — believe IBD is a digestive condition, but it is in fact a systemic chronic inflammatory disorder that is way more complex than it may appear at first sight,” he notes. “The entire immune system may be affected in all organs of the body.” 

The goal is to provide more personalized care for each patient through a more comprehensive diagnosis and more precise selection of targeted therapies that ideally treat all of their conditions.

Baumgart says next steps for the research project will include diving deeper into Alberta’s unique health record data to develop AI-enabled predictive models for the course that inflammatory bowel disease may take in each patient, how they should respond to treatment, and how best to avoid complications.

“All that everyday wisdom that is captured in an electronic health record can help us to provide better care by combining our knowledge from basic science with the clinical evidence to be better clinicians and attend better to the patient as a whole,” he says.

Baumgart carried out his research through the U of A’s Data Analytics Research Core.