Cutesy, busty female characters in miniskirts and maid costumes are regular fixtures of Japanese anime and manga, but a doctor in Tokyo is trying to use their universal appeal to educate people on what they rarely talk about in public: poop.
Yosuke Ishii, a 32-year-old gastrointestinal surgeon, is developing an online game app featuring such moe characters in revealing costumes, who all bear names taken from real-life bacteria in the colon, such as Bacteroides oreiciplenus and Lactobacillus brevis.
Ishii and a network of volunteers who are developing the game have so far come up with 16 characters, each with different personalities and abilities, to keep their world, dubbed “Untopia,” safe from the evil forces.
But the true mission of the game, which will be officially launched later this year, is something quite different: raising the profile of some of the 1,000 colon bacilli that exist in our bodies, making people monitor their stool conditions daily — and ultimately getting them screened for colon cancer.
Stool tests are the most basic and common way to detect signs of colon cancer, which kills 40,000 people in Japan every year, according to the health ministry.
“Colon cancer, if detected in early stages, is pretty much curable, but most patients who come to hospitals are in advanced stages,” Ishii said. “That’s because there are virtually no symptoms in early-stage colon cancer, and that’s why screenings are vital in detecting it.”
Yet the colon cancer screening rate in Japan is just 37 percent, much lower than 65.1 percent in the U.S. and 57 percent in the U.K., according to recent statistics from the health ministry, the Centers for Disease Control and Prevention in the U.S. and U.K. charity Cancer Research. Ishii pondered how to better motivate people to get tested, then began researching the word unko.
After learning that unko, meaning poop, is one of the most frequently used words in social media in Japan (along with oppai, meaning boobs), he decided to use its quirky popularity to spread the message that people can lead healthier lives by paying more attention to their excrement. Moe characters are thus simply a tool to achieve that end, Ishii says.
While regular smartphone games are designed to make people want to pay for extra “items” to beat the virtual enemy, Ishii’s game, titled “Unkore” (taken from unko and collection), is geared toward motivating people to log their daily stool conditions. The more reports the users make on their toilet experience the more “cards” they can get online to play the game to their advantage.
So what does poop tell us? According to Ishii, who himself was diagnosed with ulcerative colitis, an inflammatory bowel disease, at age 15, poop is a key barometer of health. A stool — its size, color, firmness and smell — tells a lot about a person’s diet and lifestyle, as well as potential diseases, Ishii says.
Ishii’s Unkore project, for which he and his 50-strong volunteers have donated time, skills and ideas on a purely pro-bono basis, comes at a time when doctors and biotech companies in the U.S. are racing to explore the use of microbes that live in our bodies for medical purposes. Some doctors in the U.S. are now experimenting with fecal transplants, or taking the stool of a healthy individual and placing it into a sick patient, to treat a bacterial infection that cannot be cured using antibiotics.
Ishii set up the Japan Unko Society, an academic association dedicated to poop research and education, in spring 2013. He is now collaborating with several companies that share his passion. One of them is Unlog, a Tokyo-based information-technology venture that has developed the poop-logging app. Takashi Taguchi, the 31-year-old CEO of Unlog, launched the free iPhone app in July 2012, which has been downloaded 300,000 times so far.
Taguchi says his motivation for creating the app was personal, having struggled with allergies and diarrhea caused by work-related stress for years. After discovering that changing his diet made a big difference in his health, he decided to create an app that would let people log their toilet habits easily and without feeling embarrassed or disgusted.
Taguchi added that the key to the app’s success has been making it “usable, fun and cute.”
The illustrations for poop look like cartoon characters, and the app has stayed away from using phrases such as unko or unchi, another Japanese slang term for stool, Taguchi said.
Through the app, users cannot only log the condition of their poop but also exchange daily restroom tales. This has proved particularly popular, Taguchi says, because users can remain anonymous online and don’t have to worry about being overheard by anyone.
To his surprise, Taguchi discovered that 95 percent of the 40,000-plus active users of the app are women in their 20s and 30s who struggle with constipation.
“Female office workers are particularly vulnerable,” Taguchi said, adding that this is probably because they don’t move around much at work. “At small and midsize companies the work is so tough that many women don’t have time to go to the toilet. In some workplaces they must also share toilets with men.”
Taguchi said he wants to release an android app in the summer and an English-language version by the end of the year, adding that he eventually wants to link up with other companies to offer tips on food and other products tailored to each user’s needs. Poop apps targeting parents of young children and pet owners are also in the pipeline.
“I think it would be useful for them because babies and pets cannot keep a log themselves,” he said.