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Differentiation between pediatric irritable bowel syndrome and inflammatory bowel disease based on fecal scent : proof of principle study

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Bosch, Sofie, van Gaal, Nora, Zuurbier, Roy P., Covington, James A., Wicaksono, Alfian, Biezeveld, Maarten H., Benninga, Marc A., Mulder, Chris J., de Boer, Nanne K. H. and de Meij, Tim G. J. (2018) Differentiation between pediatric irritable bowel syndrome and inflammatory bowel disease based on fecal scent : proof of principle study. Inflammatory Bowel Diseases, 24 (11). pp. 2468-2475. doi:10.1093/ibd/izy151

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Official URL: https://doi.org/10.1093/ibd/izy151

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Abstract

The diagnostic work-up of pediatric irritable bowel syndrome (IBS) and functional abdominal pain-not otherwise specified (FAP-NOS) commonly includes invasive tests for discrimination from inflammatory bowel disease (IBD). As this carries a high burden on patients, an ongoing need exists for development of noninvasive diagnostic biomarkers for IBS and FAP-NOS. Several studies have shown microbiota alterations in IBS/FAP, which are considered to be reflected by fecal volatile organic compounds (VOCs). The object of the study was to evaluate whether pediatric IBS/FAP-NOS could be discriminated from IBD and healthy controls by fecal VOC analysis. IBS/FAP-NOS was diagnosed according to the ROME IV criteria, and de novo IBD patients and healthy controls (HCs) aged 4 to 17 years were matched on age and sex. Fecal VOCs were analyzed by means of field asymmetric ion mobility spectrometry. Fecal VOCs of 15 IBS/FAP-NOS, 30 IBD (15 ulcerative colitis, 15 Crohn's disease) patients and 30 HCs were analyzed and compared. Differentiation between IBS/FAP-NOS and IBD was feasible with high accuracy (area under the curve [AUC], 0.94; 95% confidence interval [CI], 0.88-1; P < 0.00001). IBS/FAP-NOS profiles could not be differentiated from HCs (AUC, 0.59; 95% CI, 0.41-0.77; P = 0.167), whereas IBD profiles could with high accuracy (AUC, 0.96; 95% CI, 0.93-1; P < 0.00001). Pediatric IBS/FAP-NOS could be differentiated from IBD by fecal VOC analysis with high accuracy, but not from healthy controls. The latter finding limits the potential of fecal VOCs to serve as a diagnostic biomarker for IBS/FAP-NOS. However, VOC could possibly serve as additional noninvasive biomarker to differentiate IBS/FAP-NOS from IBD.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions: Faculty of Science, Engineering and Medicine > Engineering > Engineering
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Children -- Diseases, Irritable colon, Intestines -- Diseases
Journal or Publication Title: Inflammatory Bowel Diseases
Publisher: Oxford University Press
ISSN: 1536-4844
Official Date: November 2018
Dates:
DateEvent
November 2018Published
18 May 2018Available
4 March 2018Accepted
Volume: 24
Number: 11
Page Range: pp. 2468-2475
DOI: 10.1093/ibd/izy151
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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