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Clin Gastroenterol Hepatol


Title:Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome
Author(s):Rossi M; Aggio R; Staudacher HM; Lomer MC; Lindsay JO; Irving P; Probert C; Whelan K;
Address:"Department of Nutritional Sciences, King's College London, London, United Kingdom; Guy's and St Thomas' NHS Foundation Trust, Department of Gastroenterology, London, United Kingdom. Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom. Bart's Health NHS Trust, Department of Gastroenterology, United Kingdom, and Barts and the London School of Medicine, Blizard Institute, Queen Mary University of London, London, United Kingdom. Department of Nutritional Sciences, King's College London, London, United Kingdom. Electronic address: Kevin.whelan@kcl.ac.uk"
Journal Title:Clin Gastroenterol Hepatol
Year:2018
Volume:20171007
Issue:3
Page Number:385 - 391
DOI: 10.1016/j.cgh.2017.09.055
ISSN/ISBN:1542-7714 (Electronic) 1542-3565 (Linking)
Abstract:"BACKGROUND & AIMS: Dietary interventions are effective in management of patients with irritable bowel syndrome (IBS), although responses vary. We investigated whether fecal levels of volatile organic compounds (VOCs) associate with response to dietary interventions in patients with IBS. METHODS: Adults who fulfilled the Rome III criteria for IBS were recruited to a 2x2 factorial randomized controlled trial. Patients were randomly assigned to a group counselled to follow a diet low in fructans, galacto-oligosaccharides, lactose, fructose, and polyols (low-FODMAP diet, n = 46) or a group that received placebo dietary advice (sham diet, n = 47) for 4 weeks. Patients from each group were also given either a multi-strain probiotic or placebo supplement. Response was defined as a reduction of 50 points or more on the validated IBS symptom scoring system. Fecal samples were collected from participants at baseline and end of the 4-week study period; VOCs were analyzed by a gas-chromatography sensor device. VOC profiles were determined using a pipeline involving wavelet transformation followed by feature selection based on random forest. A partial least squares classifier was constructed to classify VOC profiles by response and accuracies were determined using 10-fold cross-validation. RESULTS: Data from 93 patients who completed the study (63 female) were used in the final analysis. More patients responded to the low-FODMAP diet (37/46, 80%) than the sham diet (21/47, 45%) (P < .001), but there was no difference in response between patients given the probiotic (31/49, 63%) vs the placebo (27/44, 61%) (P = .850), with no interaction between the diet and supplement interventions. At baseline, VOC profiles contained 15 features that classified response to the low-FODMAP diet with a mean accuracy of 97% (95% CI, 96%-99%) and 10 features that classified response to probiotic with a mean accuracy of 89% (95% CI, 86%-92%). End of treatment models achieved similar predictive powers and accuracies. CONCLUSION: Fecal VOC profiling is a low cost, non-invasive tool that might be used to predict responses of patients with IBS to low-FODMAP diet and probiotics and identify their mechanisms of action. ISRCTN registry no: 02275221"
Keywords:Adult Diet Therapy/*methods Feces/*chemistry Female Humans Irritable Bowel Syndrome/*therapy Male Middle Aged Placebos/administration & dosage Probiotics/*administration & dosage Treatment Outcome Volatile Organic Compounds/*analysis Functional Bowel Diso;
Notes:"MedlineRossi, Megan Aggio, Raphael Staudacher, Heidi M Lomer, Miranda C Lindsay, James O Irving, Peter Probert, Chris Whelan, Kevin eng Department of Health/United Kingdom Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't 2017/10/11 Clin Gastroenterol Hepatol. 2018 Mar; 16(3):385-391.e1. doi: 10.1016/j.cgh.2017.09.055. Epub 2017 Oct 7"

 
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