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Inflamm Bowel Dis

Title:		Differentiation Between Pediatric Irritable Bowel Syndrome and Inflammatory Bowel Disease Based on Fecal Scent: Proof of Principle Study
Author(s):		Bosch S; van Gaal N; Zuurbier RP; Covington JA; Wicaksono AN; Biezeveld MH; Benninga MA; Mulder CJ; de Boer NKH; de Meij TGJ;
Address:		"Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, the Netherlands. Department of Pediatrics, Spaarne Gasthuis, Hoofddorp, the Netherlands. School of Engineering, University of Warwick, Coventry, United Kingdom. Department of Pediatrics, OLVG, Amsterdam, the Netherlands. Pediatric Gastroenterology, Emma Children's Hospital/Academic Medical Center, Amsterdam, the Netherlands. Department of Pediatric Gastroenterology, VU University Medical Centre, Amsterdam, the Netherlands"
Journal Title:		Inflamm Bowel Dis
Year:		2018
Volume:		24
Issue:		11
Page Number:		2468 - 2475
DOI:		10.1093/ibd/izy151
ISSN/ISBN:		1536-4844 (Electronic) 1078-0998 (Linking)
Abstract:		"BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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. 10.1093/ibd/izy151_video1izy151.video15786446046001"
Keywords:		"Adolescent Area Under Curve Biomarkers/*analysis Case-Control Studies Child Child, Preschool Diagnosis, Differential Feces/*chemistry Female Follow-Up Studies Humans Inflammatory Bowel Diseases/*diagnosis/metabolism Irritable Bowel Syndrome/*diagnosis/met;"
Notes:		"MedlineBosch, Sofie van Gaal, Nora Zuurbier, Roy P Covington, James A Wicaksono, Alfian N Biezeveld, Maarten H Benninga, Marc A Mulder, Chris J de Boer, Nanne K H de Meij, Tim G J eng England 2018/05/23 Inflamm Bowel Dis. 2018 Oct 12; 24(11):2468-2475. doi: 10.1093/ibd/izy151"