BioGut AI: An agentic multimodal platform for longitudinal microbiome-informed chronic disease management

The gut microbiome influences gastrointestinal, metabolic and mental health, but its clinical value is limited because microbiome data are rarely interpreted alongside clinical and behavioural context. Laboratory, microbiome, wearable, glucose, diet, symptom and medication data sit in separate systems and are reviewed episodically. The gap is not a lack of data but the inability to turn multimodal, longitudinal data into clinical insight at the point of care. We are developing BioGut AI, an agentic multimodal decision-support platform with four layers: collection of laboratory, microbiome, clinical, patient-reported and wearable data; a governed data environment that builds a longitudinal representation of each individual; specialized AI agents that analyze microbiome and laboratory features, metabolic and wearable signals, symptom trajectories and treatment response, coordinated by an orchestration layer that interprets new data against prior measurements and interventions; and an interpretable clinical synthesis that is traceable to source data, conveys uncertainty and preserves clinician oversight. The microbiome is treated as one layer of a whole-person model rather than a standalone diagnostic. The platform will be evaluated prospectively in a real-world precision-health and virtual-care setting in Alberta, Canada, across IBS/chronic gastrointestinal disease, mental health, obesity and type 2 diabetes. Outcomes include validated IBS symptom scores, HbA1c and continuous glucose metrics, time to personalized care planning, clinician review time, unscheduled health-service use, and model performance, calibration and usability. We aim to show that integrating microbiome data with longitudinal clinical, behavioural and physiological signals improves detection of meaningful change and non-response, reduces clinician burden, and supports earlier, personalized chronic-disease management. The modular, disease-agnostic architecture may extend to other chronic conditions.