Meet John C.- From Ulcerative Colitis To Building A Stool Tracking Device

A ninth inning ballpark burger. Days of relentless diarrhea. Then blood. John Capodilupo’s ulcerative colitis diagnosis didn’t arrive slowly, it hit like a truck, and it sent him into a crash course on what living with IBD really demands. We talk through the early fear and uncertainty, the 28-day hospitalization, and the chaos of juggling treatment while also battling infections like C. difficile and CMV colitis. John also shares his experience with fecal microbiota transplant (FMT) for recurrent C. diff and why the microbiome still feels like one of the biggest unsolved stories in gut health.

From there, we connect the dots between health data and better decisions. John helped build Whoop, the wearable built around continuous physiological tracking like heart rate variability and sleep, and he explains what longitudinal data can reveal about stress, recovery, and early warning signs. We dig into how sleep disruption and subtle body signals can show up before you’re sure whether you’re flaring or just paying the price for Taco Bell.

Then we get into Throne, the smart toilet monitoring system John now co-leads as Chief Product Officer. Throne clips onto the toilet and uses computer vision and sensors to track stool and urine trends passively, aiming to reduce guesswork, improve symptom recall, and open the door to research like flare prediction, medication durability, and future screening signals such as blood detection for colon cancer. We also cover the “real life” questions: multi-user households, cleaning, cost, and a privacy approach built around de-identified data and opt-in research.

If you’re curious about ulcerative colitis, Crohn’s, IBD tracking, gut health technology, or the future of smart toilets, listen now then subscribe, share with a friend, and leave a review.

Links: 

• Throne's website
• Fun article about the founding of Throne
• Buy Throne for $50 off!  or use code ListenToYourGut

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Transcript

Welcome And Guest Preview

SPEAKER_01 0:00

Hi, I'm Elisa, and I'm Ray Legend, and you're listening to Bell Moment, a podcast during real talk about the realities of IDB. This week we talked to John Cappadilupo. John is an entrepreneur and data analyst with a passion for developing new technology. He also happens to be living with ulcerative colitis, which led him to become the co-founder and chief product officer at a company called Throne. Throne is a smart toilet monitoring system. We talked to John all about Throne and how he got involved and all about what it tracks and the people involved. We also talked to him about his previous role as chief technology officer and co-founder at Whoop. We know you're going to learn so much from this conversation just like we did. Cheers.

SPEAKER_02 0:47

Hi

Sparkling Water And The Ice Queen

SPEAKER_02 0:48

everybody. Welcome to Battle Moments. This is Robin.

SPEAKER_01 0:50

Hello, everyone. This is Alicia, and we are so excited to be joined by John Capitolupo. John, welcome to the show.

SPEAKER_00 0:58

Thank you so much, Robin and Alicia, for having me. Excited uh to be on.

SPEAKER_01 1:02

We are very excited to hear your story. But the first very unprofessional question for you is what are you drinking?

SPEAKER_00 1:08

I'm very addicted to sparkling water. So uh grapefruit sparkling water right now. Yeah.

SPEAKER_01 1:14

What what is the brand?

SPEAKER_00 1:15

The Kirkland brand, but usually it's spindrift has been my my go-to lately, but ran out of those.

SPEAKER_01 1:20

So yes, big fan. We are big sparkling water fans on this show, although I think Robin has had to take a slight hiatus because it's still okay. Okay. What are you drinking, Robin?

SPEAKER_02 1:30

Then I'm drinking a bubbly orange cream. It's like an orange cream soda. I stole it from Matt. It was one of his. And I was like, I don't, I don't usually don't like orange flavored beverages at all, but it's actually quite nice.

SPEAKER_01 1:45

Well, in honor of the fact that we're going to talk about your company called Throne, I made sure that I found a royally named cocktail. So this is the ice queen. Nice.

SPEAKER_00 1:56

What's an ice queen?

SPEAKER_01 1:58

Okay, it's got muddled cucumber, and then it's supposed to have mint liqueur in it, but I didn't have it. So I just muddled some mint in there. Simple syrup, rum, and champagne. Cheers. Cheers.

SPEAKER_04 2:08

Cheers.

SPEAKER_01 2:09

All right.

A Sudden Ulcerative Colitis Diagnosis

SPEAKER_01 2:10

Next question for you, John, is tell us your IVD story. What brought you into our community?

SPEAKER_00 2:15

My story actually started a long time ago. My grandfather had alternative colitis, and he was an immigrant from a tiny country called the Republic of San Marino, which is landlocked inside of Italy, kind of like the Vatican is. And he was a construction worker. And my mom would tell stories of when they were growing up that my grandfather has this disease called colitis, and it made you go to the bathroom a lot and there'd be blood. But he still, you know, went to work every day and raised the family and things like that. And so kind of grew up thinking of him as a hero. Didn't really fully appreciate or understand what he went through. But I'll get back to why that's important, how much we've progressed knowing about the disease and the medications and stuff. But anyway, so always grew up with the knowledge of ulcerative colitis. And then went through childhood, teenage years, nothing at all. College. And then I started my first company, Woof, the Wearable Fitness Band. Started getting more into human physiology and collecting data. And then in 2026, I got diagnosed. Or sorry, 2016, I got diagnosed with ulcerative colitis, kind of out of the blue, completely out of the blue. I still remember it was opening day of Red Sox. I was at the game and I got a ninth inning tasty burger. Uh they're kind of walking around. It was like the bottom of the barrel, the thing the guy was walking with. And I was like, ah, I'll have a hamburger. And I didn't feel good afterwards. And I was like, well, I probably shouldn't have ninth inning tasty burgers. Didn't think anything of it. And then the diarrhea didn't stop. It kept going. And then it's day three. And I'm like, this is really weird. And then blood showed up. And then, you know, a week later I was in the hospital and got diagnosed. Well, it took a long time, but uh got ultimately got diagnosed all sort of colitis. And so that was kind of a weird, abrupt journey for me into it. Thankfully, with my mom and our knowledge of the disease, it wasn't a complete shock, but it did kind of dramatically change life. And I got out of the hospital. MGH here in Boston has tremendous care. And it was actually the Crohn's and Colitis Foundation's Take Steps Walk. It happened to be that day. And so I went there and got involved with the foundation and then kind of went about my way. And now I'm on the National Board of Trustees with the Crohn's Colitis Foundation and really passionate about being an advocate for the disease and also just trying to figure out more about what's going on as a techie and someone that's into data, really passionate about trying to unravel the mysteries of the gut and the immune system and things like that.

SPEAKER_01 4:25

Wow, that was a really good synopsis. I'm guessing there's a few things in between there that probably have stories attached to them. You so you do not recollect having any sort of symptoms at all up until this terrible tasty burger incident.

SPEAKER_00 4:39

Yeah, no, really out of the blue. So I no stomach issues at all, definitely never any blood, and could eat what I wanted. Like, yeah, no, no stomach issues at all. And then it really hit hard. I was in the hospital for 28 days. I lost 60 pounds and I had a C diff infection and CMV colitis on top of that. It was like everything all at once. But yeah, it was really out of the blue. So strange. And then thankfully, now with different medications and stuff, I've been in remission for a couple of years on Antivio, but it was a winding journey of all kinds of different biologics after that.

SPEAKER_01 5:10

I'm sorry, CMV colitis.

SPEAKER_00 5:13

Yeah, so it's pretty it's pretty rare. It's a viral infection. CMV stands for some type of viral infection, and it causes colitis like symptoms. And it's particularly when you're immunocompromised. And I guess because the long story of the diagnosis was they thought it was really bad colitis flare, so they're pumping me full of steroids, but it ended up being C. diff. And I don't know how they missed it or whatever. And so that really just weakened my immune system and let the C. diff run rampant. And then that weakened my immune system for some reason the CMV colitis happened as well on top of that. And so it was a fun game of changing medications to try to battle the viral and bacterial infections while also keeping the immune system tampered down for the colitis. And they did it in the end, but it was a winding journey to figure that all out.

SPEAKER_01 5:56

Whoa, yeah. That feels like it's quite the crazy puzzle to try to solve. And also, what a very dramatic way to enter into your part of the community. Unfortunately, you were still a part of the community because of your grandfather. I think I saw that you had fecal microbiota transplant for the C. diff. Was did that happen at that time?

Recurrent C Diff And FMT Relief

SPEAKER_00 6:13

Yeah, so not at that time. So I that was my first C. diff infection was when I got diagnosed with the colitis. And then things were actually pretty good with my colitis, but then I was always have anxiety that I was coming back. But every time I thought I was having a flare, it was C. diff. And for some reason, for me, it just kept coming back and progressively went on stronger and stronger antibiotics. And then three weeks later, when I got off of them, the C. diff would come back. And they asked if I'd be willing to do the FMT. And I said, sure. I looked at the data and it's super, super effective. And I swear, I had the fecal matter transplant over two days. It was like the pill format. And within three days, the C. diff symptoms went away. And I have not had C. diff since 2017.

SPEAKER_01 6:53

It's so wild, isn't it? Like the science of that is so odd.

SPEAKER_02 6:57

It's wild. And I was gonna ask you how many, like, did you have C diff again? Because it comes back. That's what it does, especially with people with IBD. So yeah, that makes sense. And it also really sucks.

SPEAKER_00 7:08

Yeah, yeah. It's it's not it's not fun. But yeah, I've I was shocked how well it worked. And thankfully for me, I I haven't had recurrence of it, but it was night and day, like just crazy within three days, I swear. And the science of it's so fun and how little we understand, and you know, even like the one percent of the microbiome or whatever we know, and like how does it take over from my microbiome? Like there's just a lot of unknowns, but the fact that it works so well, I'm glad that tool tool is out there. But yeah, that was a wild, wild journey.

SPEAKER_02 7:35

I'm always like my brain thinks about who was the first person that thought that that was gonna be a good idea, you know, like how do their brains work? But I think about that kind of stuff. Like when I'm driving in Colorado and I'm driving into the mountains, I'm like, who thought? Like, can you imagine when they were like traversing the country in covered wagons and horses and on foot? They were like, Yeah, we're gonna climb those mountains. I think about that. The same thing in this kind of thing. Who thought of taking somebody else's poop and then repopulating the microbiome and the good bacteria in your gut? Like, I'm like, who thought of that? I mean, I know we can look it up, but I just how their brain works. You know, I can't look up how their brain works.

SPEAKER_00 8:13

I could so uh I was very curious about it too, and I forget the exact story now, but it's actually an ancient like technique in medicine and in the in the east and China. I think it's something called like dragon soup or horse soup or something like that, in like thousand BC or something, and it would be maybe for horses or it was for humans, but it was it was a more vile way of doing it, but that's how they did it back then. But there was medical benefits that they observed, and so there was even early on this evidence that the microbiome that today we understand a little, but back then they definitely didn't know about, but there was evidence that there is really strong power in our guts to control how we feel, yeah.

SPEAKER_01 8:47

So the pill form probably works a little bit differently, I would imagine.

SPEAKER_00 8:51

Didn't notice anything, it's like 30 pills over the course of two days, so it's quite a lot of matter that they're transplanting, but you have 15 on one day and 15 on the next day, at least my the protocol I did, but didn't notice anything at all. You know, just made a little nausea from having 15 pills, but totally fine. Yeah.

Whoop And Continuous Body Data

SPEAKER_01 9:08

I want to ask you about Whoop, because Whoop came up in our conversation with Dr. Charlie Lees, who's a researcher out of the University of Edinburgh, and he mentioned Whoop, but he's like a big runner guy, like long distances, hard terrain, kind of like semi-crazy kind of runner guy. Sorry, Dr. Lees, if you're listening. But so he uses Whoop on his own, like as for tracking his thing. So what exactly is this? Because clearly I'm not one of these runner people. So tell me a little bit more about Whoop.

SPEAKER_00 9:34

Fun story. So we started the company back in 2012, crazy thing, 14 years ago. And when we started the company, wearable wasn't a word yet. Fitbit had just come out with a thing that you put in your pocket to count the number of steps you took. Nobody was monitoring their heart rate continuously throughout the day. And Whoop also has like a sleep tracker component, and people would push back and be like, I don't want something to track when I sleep, or well, what's the value in this? I know when I sleep poorly, like I don't need a thing to tell me. And so that was kind of the state of the world back in 2012. But the story was I went to Harvard to study astrophysics and computer science. I thought I was going to become a professor, my dad's a professor. But going by my way, my sophomore year, I met a Will Ahmed, who's a CEO and founder and still there. And he was a captain of the squash team at Harvard and super competitive person, but he would always over-train and he had no way of objective data about his body about when he needed to rest. That's really the impetus behind Whoop was to figure out how we can listen to the signals in our body to understand whether we're ready to go or we should take a rest day. I got excited about this idea, just collecting data on the body. We didn't know quite how we do it, then giving recommendations, and we didn't even know how important sleep was back then to all this. And so that's kind of the origin story of Whoop. We brought on a third co-founder, Aurelian. I dropped out of Harvard, those two had graduated and set off in the summer of 2012 to build what would become a wearable. So Whoop is a very plain looking device that you can wear on your wrist. And actually, now you can wear it anywhere in the body. We sell like different pieces of clothing and stuff like that. But it's a sensor module that measures your heart rate, a metric called heart rate variability, which looks at your autonomic nervous system, motion, pulse oximetry, and things like that. And importantly, in differentiated, Whoop tracks every single beat of the heart. It doesn't like turn off or downsample when you're not doing stuff. It's continuously capturing that data. It doesn't have a screen. You can't order Uber on it. It's not a smartwatch. It's slowly focused on gathering physiological data and then turning that physiological data into actionable insight to improve human performance. And so that we look at strain, how much stress you put on your body, recovery, how ready your body is to go again, and then also sleep and how you can improve your sleep. That was how we set off. And on the, I guess, go-to-market side for Whoop, we started with professional athletes, collegiate athletes, the military and Olympians. And so we weren't a consumer product at first, but we thought if we could make our product work and have value for people who arguably need the data the most, then we could kind of go downstream. And so Whoop today still has this really aspirational brand working with the best athletes in the world. But you know, there's over 2 million plus people on Whoop today. Uh, most aren't aspirational athletes, but it's for people that really want to understand their body better. And the really fascinating thing is with Whoop, with all this physiological data we're collecting, it wasn't just useful for making a very interesting product, but we are actually able to collect for the first time longitudinal data sets on humans outside of the laboratory. So night after night, how did you sleep as an individual? How did your heart rate change? How did your breathing rates change? And we're able to start doing some more clinical or medical applications. And so COVID-19 came out. We published a paper showing how we could predict COVID-19 infection. We're looking at things like with pregnancy research. My wife actually runs all of RD at Whoop still today, and she looked published a paper showing how heart rate variability fluctuates and can predict pre like early term births. And so we're kind of just seeing for the first time amassing a huge data set on the human body night after night can really say a lot of different interesting things. And so that that got me excited and we continued kind of pursuing that scientific angle too.

SPEAKER_02 13:02

Love that. And we had Josie on, she did research on heart rate variable variability in IBD and predicting flair. Is that what it was, Alicia? Yeah.

SPEAKER_01 13:12

Yeah, I was just about to say, John, did you look at your own data when you were diagnosed and see like how did it change as you were going through different phases of uh flair and recovery?

SPEAKER_00 13:22

Yes, definitely. There is, at least in my data, very strong patterns with heart variability and kind of activation of the sympathetic nervous system and things like that. I'd say for me, one of the most useful pieces was the sleep piece. I thought, at least for myself, if my sleep consistency and length of sleep gets altered, either because of my lifestyle or behavior or because I'm getting sick or inflamed or something like that, that's a pretty good indicator that something's going wrong with my gut. And so just it's really interesting seeing all these different pieces. I've seen actually some of the work done with Hari variability and predicting flares. It was something I was very excited about potentially doing with Whoop, but then COVID-19 hit, unfortunately. And so we never got to do those kind of trials. But it just goes back to this thesis that I'm still so excited about of yeah, actually, if we collect a ton of data on people and all these different biomarkers, uh, we should be able to answer a lot of questions that as a patient's frustrating we don't have the answers to. Am I flaring or is it Taco Bell? Uh like I mean, it could be either.

SPEAKER_01 14:21

It could be both. Who knows? Could be both. Okay. So it sounds like you did that at Whoop, sounds like you went, and then you've now moved on to your own starting your own company

Throne Clip On Smart Toilet

SPEAKER_01 14:29

here. Tell us about Throne. Why? Number one, why number two? Tell us all about like the company and what are you doing? And because you're you're not, you haven't come to market quite yet. Is that correct? At this point, we have launched uh March 10th.

SPEAKER_00 14:42

We launched. But yeah, now I'm a co-founder and chief product officer of a company called Throne. And so two other co-founders as well, Scott and Tim. My journey there actually, so I left Whoop in April of 22 and started doing a lot of investing. And one thing I was passionate about was trying to find a smart device to help me on my IBD journey. And I thought that would take the shape in a smart toilet. But the problem with smart toilet, there was a few people working on it, is as a consumer, if you buy a toilet, an actual toilet, then you have to hire a plumber to install it, like it's just not going to get off the ground. Then I met Scott and Tim, who had just started out on their journey with building Throne, and they had kind of a best best way to describe it as a wearable for your toilet. So it clips on to the rim uh uh of your toilet and then uses a camera and acoustic sensors to use computer vision and some other algorithms to analyze your stool and urine kind of continuously and passively. And that obviously got me excited because instead of keeping a logbook or things like that, so when the doctor asks how things have been going, you can have an objective view of the data. But then also, just like with that whoop, now we can start saying really interesting things. Can we start predicting flares because of slight changes in the texture or morphology of the stool? I think the answer is probably yes, because the inflamed colon is going to change that, but who knows? And then urine and dehydration, and then other applications, even like with colon cancer and seeing blood, blood in the stool. And so got really excited. I invested and couldn't let it down and ultimately joined up forces with them and been about a year and a half now that I've been with them full time. So thrown, that's that's the problem. I actually have one here. It just clips right on right on the toilet.

SPEAKER_01 16:13

Not very big.

SPEAKER_00 16:14

No, nope. It is pretty small device that hangs off like one side outside the toilet and one side in the toilet, and it just clips right on the rim of the toilet. And inside the toilet, it's just a very small sensor module, and we use computer vision to analyze kind of all this data with both stool and urine. And I think the coolest part and a lesson learned from Whoop is you need to get people to collect the data and make it as effortless as possible because no matter how excited or how passionate you are about trying to collect this data, if it's a burden, ultimately it's going to fall off. And so with Throne, we have this kind of hands-free mode we call it. So as long as you have your phone with you in your pocket, you don't have to have the app open. You walk up to your toilet like normal, there's a proximity sensor, it turns on, Bluetooth pairs with your phone, and then it automatically assigns the data to you. So you, as a user, don't have to change how you go to the bathroom at all, just completely normal. But you get the benefit of having all of this data. And obviously, we're just getting started now. There's not a whole lot of literature out there. We probably have the world's largest data set like this. So we're excited to be teaming up with people like Dr. David Rubin at the University of Chicago and other researchers to figure out what the disease that we haven't known and whether it's IB it's not purpose-built for IBD, but obviously that's a key segment for us. Yeah.

SPEAKER_01 17:29

You answered one of the questions I had, which is going to be like, how does it know that it's my poop versus my partner's poop? You know, but sounds like the phone is the is the key there. Are you but you're able to have multiple profiles for one device? Is that correct? Okay.

SPEAKER_00 17:41

Yep. So up to six profiles per device now. And there are so most people we found like 99% of people go to the bathroom with their phone. So that's how the hands-free works. But if you don't have your phone, maybe it's the middle of the night, there are two hard-coded buttons on the device that's hanging outside of the toilet. And so you can always start and stop a session by clicking a physical button. So that's up to two people. Yeah, that's kind of the fallback.

SPEAKER_01 18:04

Robin, this what this first brought to mind is our conversation that we had with Stacey about how like you guys blew my mind about the fact that your JPouch poop is not normal poop, right? So it's not normal poop. No, so like, is there a way so that you can kind of tell your throne, like, hey, I have a JPouch, so I'm always going to have loose poop. And so that's quote unquote normal for me, even though clinically it would probably be considered abnormal.

Personal Baselines And JPouch Reality

SPEAKER_00 18:31

Great point. So today that feature doesn't exist, but that's actually something we definitely should add. Two things. One, and this was even true with Whoop, we found that there's when you're like kind of scoring and grading the physiological data you collect from wearables, there's kind of the objective truth measures, clinical guidelines, or whatever that you think the measurements should fall in. But actually, what turns out to be more interesting is personal baselines. So, how do how does day 30 compare to the last 30 days for you as an individual minus everybody else? And so a lot of our algorithms kind of adjust to you as the user, and then we alert when things are different than what has been normal for you. But two, we all we're developing this kind of AI gut health coach. AI is, you know, uh the big buzzword now, but it's really awesome what we can do, and you can tell the AI more information about you, your lifestyles, JPouch or not, and then also different foods or drinks you had throughout the day, or you traveled and things like that to give us more contextual information when we're when we're grading these things. But I think this brings up a great point with JPouch poops and things like that. We don't probably have that big of a data set anywhere on this, and so that's a really exciting opportunity with throne and kind of citizen science almost of hey, let's get a whole bunch of people with JPouches on throne and a professor and see what is normal, what isn't normal, how do things change? And I think that's a really exciting opening.

SPEAKER_02 19:50

This needs to happen, John, because we cannot use the Bristol stool. Yeah, that J Pouch can't use that for that. So, you know, when you go to the doctor, like, how many stools have you had? How many liquid stools have you had? Whatever. I'm like, that's not a valid question for me. I say we, but you're the one with the company. So we need to go.

SPEAKER_01 20:08

I feel like we need to be co-authors on this paper for as many like J Pouches as we have on this show. We might be the primary source of uh uh recruitment.

SPEAKER_00 20:18

Yeah, no, definitely, definitely. But like that's it's fascinating, right? Like that it's uh it's a common lived experience today, right? And it's the science of it and the understanding of it so so young. Hopefully, with Rhone and other tools like that that are coming online, we can start unraveling a lot of these questions.

SPEAKER_02 20:34

Yes, okay.

What Throne Tracks Daily

SPEAKER_02 20:36

Because it's the camera and sensors based, like this is not lab work. This is not stool samples, right? So I just want to make sure like you're not getting that kind of information, you're analyzing it from a different perspective to build a baseline. So it's not like this is a stool sample kind of situation where there's labs being done.

SPEAKER_01 20:56

So can you just, I mean, not like interacting with the poop to test it.

SPEAKER_00 21:01

Yep, 100% correct. So there's no sample direct sampling of the stool going on. And that was a conscious design choice because there's kind of that ick factor. I'm I know I as a patient should do more stool samples than I do because I don't want to deal with it basically. And so we want it to be very convenient. And once again, because it's not just for IBD patients and the willingness kind of goes down, especially if you don't have IBD. But I think the analogy we like to use is, you know, still do the microbiome test maybe once every six months, or the stool sample, of course, with the doctor and stuff like that. But those metrics probably change slower on the order of months, and those are more clinical measurements. And maybe on the microbiome side, we're still not even sure how to interpret all those things. But this is more of daily functional gut health. So exactly we predict the Bristol stool scale using the computer vision, frequency of stool, regularity of stool, and then some other things like the texture and the morphology of the stool and floating or sinking that is important in the clinical literature, but we don't really understand why. So those are the things we capture visually, but we're not. Capturing like the calprotectin, fecal cal protectin in the stool or microbiome. But like Whoop actually, so just came out with a feature, and I don't know if seen function health and all these other companies that do blood testing. So you can kind of go do a blood test every six months and get like 200 panels done. And so that's kind of like the microbiome or direct sampling of the stool. And then there's the whoop that you wear daily and improve your cardiovascular metrics by exercising, things like that, or throne that you use daily and see how your functional health is changing, and then go get these more invasive and but higher fidelity measurements once every six months or something. So that's how we think about that. But I will say the exciting thing is even without direct sampling of the stool with computer vision, you can do a lot. And then there's a technique called spectroscopy where you can start to analyze kind of the chemical components of a sample using light. And so that's some techniques we're developing right now. And remains to be seen how sophisticated we can get with that. But I think the bar is quite high, or I don't know which way, but we could tell a lot with just computer vision. With and there was actually a study out of South Korea that they had patients take pictures of their stool five days before and five days after a colonoscopy. And they were able to predict almost as well as fecal cow protectin the colonic inflammation and the colon on the colonoscopy just from visual. And of course, small land was like 30 people, but or six, I don't even know. But it just shows that there probably is a lot of information with these algorithms, more than we can see with our eye, that things we can't pick up or even understand. But with big enough data sets, I really think we'll be able to say a lot.

SPEAKER_02 23:34

Yeah. I mean, I would love for it to be able to tell me if I have SIBO. I just look, you know, the spectrum. I don't even know what the word you said was.

SPEAKER_00 23:41

Spectroscopy.

SPEAKER_02 23:42

Yeah, that that word, yeah. Sounded like spectrum to my brain. So that's what my brain picked up.

SPEAKER_00 23:48

We don't do it right now, but something that's even fun that we we think about too is like, you know, different sensors that you could have for how can we pick up these bacteria and things like that. So like a lot of really cool sensors out there that I think don't require the direct sampling of the stool. And so for us as a company, it's just it's a good clarifying question, but it was a conscious design decision to stay away from that just to keep it as friendly as possible.

SPEAKER_02 24:09

Totally. I mean, IBD people obviously, you know, they don't care about that, but the general public, I can see how you would want to go in that direction because he, as we know, people don't even like talking about poop or going to the bathroom, but IBD people are not. We don't care about that.

SPEAKER_01 24:22

So I understand why you would want to invest and get involved in this company and your uh sort of impetus for this. What's Scott and Tim's deal?

SPEAKER_00 24:29

Yeah, no, great question. Fair question. So what's wrong with them? Fun origin story. They were in the Austin tech scene and in very different companies. And I think they're at like a poker night or something one night, and they started talking about what companies would you want to start, but like you wouldn't want to be associated with, or have your mom know you did. And most people have talked about like vice industry stuff, sex, drugs, rock and roll. And I think Tim said no, a smart toilet or something like that. And Scott immediately quipped back, like, Oh, you'd obviously name that company Throne. And they kind of laughed, didn't think too much about it. Scott's mom is a geriatrician, and so they couldn't, they wanted to start a company, they were thinking of different ideas, and there's like, let's explore this. And they asked Scott's mom, is there any value in poop data, like clinic uh medical value in poop data? And she, as geriatrician, said, like, she stopped giving out her phone number to her patients because she can't stand getting any more poop pictures because apparently the elderly patients they care about their family, their kids, and their poop, is uh, I guess, the joke. And it was just nonstop. And that like the light bulb went off that hey, actually, there must be medical information in this poop if there are people are kind of intuiting that something's wrong just by looking at it. And so they kind of dove into the literature, learned about IBD, learned about IBS. There's also like a secular movement happening with fiber and gut health in general. They say like fiber is the new protein and all these supplement companies and stuff, and even seed probiotics, prebiotics, who knows what's good, what's bad, but that's also happening in the background. And so it seemed like gut health is kind of this next area. And there's also the urinary health side with hydration and uh some other things we can do there, urinary flow rate for prostate health as well. And so it's kind of seemed like the bathroom wearable was a wide open category and could be the next sleep space. Then that's kind of like at the beginning, West saying how absurd it was that we started whoop if people didn't want to monitor their sleep or have it in the bedroom and things like that. Very common reactions to throne. But it's funny having lived through this now, it was like very similar reactions. And now 15 years in, it's almost weird if you don't monitor your sleep or something like that. Yeah.

SPEAKER_02 26:33

You're judged if you don't have some kind of wearable that's monitoring every single biomarker that's happening on your body.

SPEAKER_04 26:42

Yeah.

SPEAKER_02 26:42

As I as I show you my ring.

SPEAKER_04 26:44

Yes.

Cleaning Battery Life And Setup

SPEAKER_01 26:46

The question I do have, which that right after like, how does it know I'm the one pooping was how the heck do you clean it? Do you need to clean it? I mean, and like, does do cleaning products affect it in any way? Because I mean, like, you know, people are using some pretty harsh chemicals in their toilet.

SPEAKER_00 27:01

Yep. No, great question. I would get it all the time. The I I know can't see a picture, but throw size.com. Uh, you can see, but those camera module that's in the toilet is very small, first of all. And two, it's actually pretty high above the water basin. And so it's very infrequent that splashes, I guess, get up there. Uh, it definitely happens, but it's not as close to the water as you think. It's like as often as your toilet seat gets dirty, I would say, or maybe like the toilet rim gets dirty, is kind of where the level where the camera is. So kind of designed to minimize splashes. But then it's made of material with antimicrobial properties on it and also totally safe to use kind of alcohol swabs and even a little probably bleach, but I wouldn't use too much. But it's safe for a little bit of exposure if you're cleaning your toilet and gets exposed to it. But you can totally just kind of swab it off with an alcohol wipe, and the material is a very soft plastic, so it kind of comes right off. And I think the other cool thing with throne is we're conscious of the fact that we don't want you like taking it on and off the toilet all the time. It's probably a little gross, but so it has 30 plus day battery life, so you really don't need to charge it up that often. And we ship with a 14 or 13 foot long uh USB cable. So if you don't have an outlet right next to your toilet, hopefully there's an outlet somewhere in your bathroom, and with 13 feet, you can usually get to it. So you don't really ever have to take it off your toilet to charge. That's just a common kind of like Ick factor question.

SPEAKER_02 28:18

Yeah, you say that, but I just make it just makes me want to say everybody poops. Come on, everybody's got a toilet, you have to clean your toilet. Hopefully, you're cleaning your toilet more often than every 30 days. So I'm no judging your if you don't, then that's it's you're I'm judging, Robin. I'm not judging.

SPEAKER_01 28:35

I am judging. I'm sorry, but if if anybody's listening and you're not cleaning your toilet more than every 30 days, we listen and we don't judge. Robin, I've never promised that. Never. We don't judge.

SPEAKER_02 28:46

Okay, so you mentioned that you launched.

Launch Details Pricing And Availability

SPEAKER_02 28:49

What does that mean? Is this available to the general public? Can they go to your website?

SPEAKER_00 28:54

Yes. So we launched early March, so it's totally generally available now for the US. Thronescience.com is the only place we can buy it right now, a direct consumer. It's $400 for the hardware, and then there's a six dollar a month subscription fee. And you can have multiple users on the device. We're shipping now. And so have users starting to grow our awareness and market it. But hopefully check it out.

SPEAKER_02 29:15

Do you have any influencers using this device?

SPEAKER_00 29:19

Yes, quite a few. I think the biggest is Dr. Karen Rajan from the UK. He has like 10 million followers across Instagram and TikTok. He makes really great general GI content. It's not IBD specific at all, but just generalized GI content and really has kind of popularized the science of GI, mixing the medical clinical angle and then like supplements you can try at home and what things mean. And also just getting people to talk about poop and be less embarrassed by it and things like that. And so he's he's our chief of science, and one helps us uh with the product, but also a lot with the marketing and communications of it.

SPEAKER_02 29:54

And my marketing brain immediately goes to it's available in the US and he's in the UK.

SPEAKER_00 29:59

Yes. He reached out to us, which was quite flattering, actually. Uh, but no, he's uh the the top, our top pick and just a tremendous guy to work with and has a huge audience. And but like we launched in the US mainly, this is more like on the tech and building a company side of things, but it's just a lot of work to set up like international shipping and then the taxes, translations, and everything like that. And so totally hopefully will be international within the next year, especially Europe, kind of the next foundation. And it's interesting. I don't know how IBD is over there uh compared to the US. You know, a problem in the US is is something we're gonna foundations, the advocacy and like let's go there and talk about it and things like that. But in Europe, we don't have any of these egg factor questions. In Germany, their toilets have like a poop shelf that actually the way that the the toilet is designed has a little shelf basically for you to visually inspect the stool before it goes down. And so there's more of a culture of appreciating stool and the medical information and how much it can tell you about your body than there is in kind of the puritanical US culture. And so we're excited about going international for sure.

SPEAKER_02 31:04

I was just about to say, we're so uptight over here about that kind of stuff. Let me tell you, you're laughing, Alicia, but those toilets with the poop shelf. I was not in Germany, I haven't been to Germany, but I can't remember where I was in the UK. I was like, this is so helpful having a poop shelf. I can look at my poop. You're laughing, Alicia, but it's so helpful.

SPEAKER_01 31:25

I'm laughing about the poop shelf number one. And also John is like, you get to appreciate your poop. I'm sorry, that just tickled me. Wow, okay. I'm sorry.

SPEAKER_00 31:38

I look at some poop pictures too too much every day, I think, between IBD myself and throne and developing the algorithm. So lovely.

SPEAKER_01 31:46

Uh you know, of all the people who appreciate poop, I think David Rubin is high on the list. And so I'm curious, did he also approach you? Did you approach him? What has been kind of his contribution as he's been talking to you guys about the science? Because you mentioned like doing some research. So tell tell me a little bit more about your collaboration.

SPEAKER_00 32:03

Yeah, definitely. So it was actually like a freak accident. Scott somehow is hanging out with his like nephew or something in Austin, Texas. And Scott was telling him, I'm starting this company throne, it's gonna look at poop. He's like, Oh, you should talk to my uncle. He's like kind of the guy. And Scott's like, he called me, I had invested, and he's like, What do you think about Dr. David Rubin? I was like, Oh, yeah, you should we should definitely talk to him. Yeah, and so we got connected that way. But I knew him through my work with the foundation. He he led the National Science Advisory Committee at the foundation for a while, and so multiple angles of attack, I guess. But he was very excited about it. And every GI we talked to, including even my own personal GI for that I see, finally having objective information when they see patients, you know, how has it been the last six weeks or six months? And as a patient, it's recency bias. If you haven't written it all down, it's like, I don't know, last two weeks have been pretty good. And then it's like all your blood levels are all over the place. And it's like, has it been really good? And I've experienced that at least a lot. And so GIs have been universally excited about having an objective source of information, and so that's really the foundational work with Dr. Rubin, what we're starting with, and pretty much everywhere we'll follow this playbook of just validating what we're measuring, showing that it's real, it works. How does it compare? The first study is really asking the question how does it compare against patient recall? Obviously, like with this objective source, hopefully it's better, but maybe you don't use the toilet as much. And but really the question is how bad is patient recall? Because how variable is it across a hundred different people if we actually have this objective source? I a lot of the clinical studies, that's the major endpoint is patient recall instead of anything objective. And then from there, I think flare prediction is always like kind of the holy grail in in my mind, at least, just what's the trajectory of the course. But then I think also another potential research project, we haven't started this one yet, but I find really exciting, is understanding the thing they call it like the durability of the medication. So, how do we know when a biologic stops working for a patient? And instead of waiting for a flare to happen, I just happened to me with Humera. I developed antibodies, and the only way I knew was I had a flare, but obviously my body was probably slowly titrating up antibodies along the way. If we catch it early, can we do something about it and prevent the flare? And so just are we able to observe the stool passively and then make those kind of observations? So I think those are some exciting research projects that I will be tackling.

SPEAKER_02 34:18

That is very exciting, and it makes me think about when you're in a flare and you are going to the bathroom so much, unless you are like have a whiteboard next to your toilet and you're literally doing hash marks. How are you gonna remember? I mean, at one point I was going to the bathroom about seven times a night. And then my doctor said, Well, how many times during the day? I'm like, There's no way for me to count that. I just know seven times a night because I wake up and I look at the clock. And then I'm like, I'm going to, and I just went to the bathroom 30 minutes ago and I just went to the bathroom 30 minutes before that. So, like, double it during the day. I mean, what am I sleeping six hours? Oh, I'm being generous, six hours. I'm in bed for six hours and getting up every half hour to go to the bathroom. So, but having something like this, that's you don't have to when you're feeling bad, you're not going to be able to track that you're going to the bathroom 21 times a day.

SPEAKER_00 35:06

Yeah, 100%. And you know, those changes, they're subtle too at first. And the subtlety might matter and changing from seven to five. It's getting better. And, you know, and so you can start to make decisions sooner instead of waiting for the like very obvious things, like, okay, now I'm not going to the bathroom at all at night. And so I think hopefully this opens up a whole new era of how we can manage the disease. But I think even for people that don't have IBD, I think GLP1s is a big topic right now, and that definitely messes up with your gut and especially gut motility, constipation becomes an issue. And then all of a sudden it's like, oh, I haven't gone to the bathroom in four days. And how do I get back to normal and things like that? So I think frequency IBD definitely uniquely has a problem there. But even just in the general population, it's something that's hard to keep track of.

SPEAKER_02 35:51

You mentioned colon cancer too, and then just like I guess it would be measuring blood and stool. Is there other applications there for colon cancer, or is it just the same general concept of scanning frequency?

SPEAKER_00 36:04

For colon cancer, uh not this generation of the device, but ultimately what we want to do is develop a device that can look for blood in the stool, which is the hallmark of colon cancer. It can be other things, but we wouldn't be a diagnostic tool, but it could be a screening device, things similar to how the Apple Watch alerts you to atrial fibrillation. It doesn't diagnose you with it, but it's like, hey, something might be going on. And with the rise in prevalence with colon cancer, it just became the number one killer cancer for people under 50, seems to only be increasing, just having early warning systems. Because if you catch it early, it's you know relatively benign as as far as things go. But when it gets to later stages, unfortunately, it's not. And so we have the opportunity, the data is there, we're just flushing it away. And so that's a goal of ours. And then I think with the blood detection, obviously will have IBD implications as well.

SPEAKER_02 36:53

So you should also think about that flushing it away. If that's not a part of your tagline, it should be. I'm sorry, my marketing brain is like yes, yes.

SPEAKER_00 37:02

That that is that is a line to me. Uh, we have used okay good.

SPEAKER_01 37:06

I was gonna say I think I think Robin might be interviewing for a job or something. Because frankly, if you're gonna put somebody in charge of your microing, it's probably she would probably be perfect for it. She's like over here bringing it out. I love it. Yeah.

Privacy Opt In Research Model

SPEAKER_01 37:22

So okay, for the research though, it sounds like all the data that is collected on everybody, you're able to use that as your own personal self. But it sounds like the company also can kind of take anonymized data. Obviously, you're not like, well, we're looking at Robin Kingham's poop and use that towards research purposes. Is that correct?

SPEAKER_00 37:37

It's actually one of the first class principles that we developed at Whoop that differentiated us from other wearables, and that I carry personally and Scott and Tim share with us here at Throne is you, the customer, are not the product. And so we will only ever look at anonymized, de-identified data and aggregate to develop our product. And then for research projects, it will actually be opted in the future. So it's not even like, hey, here's this whole thing of data, like just have at it. It'll be, hey, we're going to be teaming up with X, Y, and Z to do this. Would you like to donate your data or would you like to contribute your data in this fashion? And so that is a very strong core principle of Berthrone.

SPEAKER_01 38:10

I mean, I highly doubt that anybody would be like, no, don't use my data, but it just seems like I guess you know.

SPEAKER_02 38:16

I was just about to say then too, you'd be surprised.

SPEAKER_01 38:20

I'd be like, I'm fine. Feel free to do whatever you want with it. Yeah.

SPEAKER_02 38:24

I'm always like that. Please use my data if it's gonna help somebody else. Please, please, please.

SPEAKER_01 38:28

Exactly. Like, yeah, like you're right. If this makes colon cancer screening easier or flare prediction easier, great. Feel free. So you have a strategy to sort of start expanding outside of the United States. But I do you have other researchers that are like kind of approaching you to work with you? Have they brought you research ideas? Like, how does that work? If somebody has an idea, like say I came up with a novel idea and I'm like, uh, Deer Throne, I would like to partner with you to track whatever. How does that work?

SPEAKER_00 38:54

So uh the honest answer is we're a person startup and still figuring it out. So just send us an email.

SPEAKER_01 38:59

Wait, there's only eight of you?

SPEAKER_00 39:00

Yep. Yep. Uh wow, okay. Yeah, yeah, yeah. So we're small with AI tools, it's amazing how how productive we can be, but very small and nimble. And it's just so much fun. To answer the question, we we welcome it. A few research, actually, like my personal GI got excited and started talking about ideas with me and things like that. And so we really want to contribute. I think research is a great way to do that. It helps us build the brand and credibility and trustworthiness. And I'm personally very motivated to figure out these questions, and so just get in contact. And I think there are a whole bunch of researchers have, and even some like pharmaceutical companies and things like that. It's very early discussions all around. But one of the fun ones, actually, there's a GI, not IBD specific, Beth is real or Bregon Wounds, I forget which one here here in Boston. And it made the rounds on CNN, but it was like if you're on the toilet for more than 10 minutes, you have a 46% chance increase of hemorrhoids or something like that. And so we have some of those features I'm thrown where we automatically say, like, hey, you've been on the toilet for a while and things like that. But so even doing some research on just bathroom habits, behaviors on the toilet, and how that's changing with smartphones and what it means for constipation and hemorrhoids and stuff. And so we're running the gamut of research. And definitely, if you're listening and excited about this, I'm I'm probably equally excited. So please get get in touch. Yeah.

SPEAKER_01 40:13

Yeah. Speaking of the whole like, if you're on the toilet longer than 10 minutes, is I have heard that there's a number of, especially gastroenterologists that are like, don't take your phone into the bathroom because people sit on their phones and ding around, as my dad would say, and then they are on the toilet too long. And like you said, there's an increased rate of like hemorrhoids happening with people. So I heard it's like perhaps not the bathroom habit that we're used to talking about. It's that your bathroom habit is that you're like in there getting distracted by, you know, Instagram or some stupid game that you're playing. And so you should probably not hand maybe bring your phone, but don't handle your phone while you're in the bathroom because you still want your uh your throne to turn on when you're in there.

Food Context Blood Detection And Next Steps

SPEAKER_04 40:50

So exactly.

SPEAKER_01 40:51

When you're setting up your profile for your throne, like what are the questions that people need to answer? Because I'm assuming like you probably want to know that for instance, like if Robin were to get one and I were to get one, Robin has Crohn's and I don't have Crohn's, right? So that you would be able to say, okay, if we're only pulling out data from people who identify as having an inflammatory bowel disease, this is the data we look at. So what what are the questions I would need to answer?

SPEAKER_00 41:12

Yep, it's all like there's a standard like profile birthday and things like that, an email. But really, the only one is disease state, if any diseases you have, or even things like food sensitivity, gluten sensitivity, it's optional. You could skip it. But like you said, it helps us make the product better. You probably have a better product experience. And then with this AI gut health coach, we have like an intake questionnaire and learn more about you with these AI tools. We can kind of learn over time as you tell us more about your lifestyle. And so, really, just one, we need to know if any disease. And I think something we're gonna start asking if we don't right now is just like, are you on any chronic medication? Like, I take a TV every eight weeks, probably good to know, or for daily medication or even a fiber supplement or something like that. But we'll learn your habits and anything else we need kind of on the fly as you continue to use the device.

SPEAKER_01 41:56

So you mentioned something about like tracking food as well, because I just I thought about this because our friend's friend of the show, Stacey Collins, is very quick to be like, Did you have beets? Like if you've eaten beets, like there might it might look like you have blood. And I just had like got some new smoothie mix from Costco that it has beets in it. So I was definitely as I was drinking it, I almost sent her a picture and was like, I promise to make sure that I don't text you with a a picture of my poop when I inevitably have to show you something. But so is that part of it too, so that at least you have a like fair warning that maybe somebody's eaten like a shit ton of red velvet cake or beets.

SPEAKER_00 42:32

Yeah, so great question. Right now we don't the blood detection is kind of our generation two product. So we we don't surface that information and it's good for us to know. And so food tracking is a part of this AI got health coach that we're coming out with. And I think when people hear food tracking, most people are like, it's like a lot of a lot of work. But the difference with us and like dieting apps, which is traditional what food tracking is for, we don't care about quantity or things like that. It's more just high-level qualities of like was it spicy to have gluten dairy? And you could say I had like cheesy eggs for breakfast, and that's enough for us to know. And then we can start to see how many times you have cheese or lactose and it starts affecting your stool. And so it's the burdens are much lower. So hopefully that encourages people to log. And over time, you know, a feature on the roadmap is integration with those existing login tools.

SPEAKER_01 43:16

That's so cool. I'm I'm like so intrigued by this, and I'm very, I'm gonna be very curious to see as you kind of continue to iterate on it, like what you come up with next. Because yeah, this is I'm sure there's a lot you can tell, and I don't pay attention to it because I'm A, not a scientist. I B, I don't have inflammatory bowel disease, and C, I'm just gonna pretend it doesn't exist. So there's that. It does exist. We talk about poop all the time. I know I can talk about other people's poop. I don't poop.

SPEAKER_02 43:43

This is not thank you so much, John, for joining us and talking to us about Throne and Whoop too, and being a research nerd

Hope With IBD And Closing CTAs

SPEAKER_02 43:52

with us. We really like research on this show. But unfortunately, it is time for me to ask you the last question. And that is what is the one thing you want the IBD community to know?

SPEAKER_00 44:00

Well, first of all, thank you, uh Robin Alicia. This was so much fun. I think the one thing the IBD community, I remember, I'll share a personal story. When I got diagnosed, I was an early entrepreneur, and one thing I remember was just the anxiety and dread in the hospital bed of what the hell is this disease? Am I always going to go to the bathroom? I can't hold down a job. My life is so gonna be different, nothing's gonna be the same. Went down a pretty dark rabbit hole. And obviously, it's a major change to your life. But one thing that I've been passionate about at hopefully serve as a role model too, is like you can still accomplish anything with IBD. I firmly believe that it's gonna look a little bit different. There's gonna be hard days and take those rest days. It seems bad in the moment, but take those rest days, but don't give up and keep going. And the world, you know, in the 10 years I've had the disease, all the different medications and new research that have come out, there's a lot of hope and reason to be hopeful.

SPEAKER_02 44:49

There is a lot of reason to be hopeful. And also go to thronescience.com and get one of these so you can contribute to the new data set that John is basically creating and collecting over there. Um, so you can be a part of that. Thank you again, John. Thank you, everybody, for listening and cheers, everybody. Cheers.

SPEAKER_00 45:08

Cheers. Hi, this is John. If you're interested in trying throne, check out the show notes for a special promo code. If you enjoyed this episode, please rate, review, and share it with your friends.