Cited by 122Gastrointestinal motility and disordersAdvanced Chemical Sensor TechnologiesGut microbiota and health

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Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome

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Rossi, Megan, Aggio, Raphael, Staudacher, Heidi M., Lomer, Miranda C., Lindsay, James O., Irving, Peter, Probert, Chris, Whelan, Kevin·2018·Clinical Gastroenterology and Hepatology

DOI 10.1016/j.cgh.2017.09.055

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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.

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Staudacher, 2017, The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in irritable bowel syndrome, Gut, 66, 1517, 10.1136/gutjnl-2017-313750 · DOI
Francis, 1997, The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress, Aliment Pharmacol Ther, 11, 395, 10.1046/j.1365-2036.1997.142318000.x · DOI · Paper page
Staudacher, 2017, Diet low in FODMAPs reduces symptoms in patients with irritable bowel syndrome and probiotic restores Bifidobacterium species: a randomized controlled trial, Gastroenterology, 153, 936, 10.1053/j.gastro.2017.06.010 · DOI · Paper page

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Authors: Rossi, M., Aggio, R., Staudacher, H. M., Lomer, M. C., Lindsay, J. O., Irving, P., Probert, C., & Whelan, K.
Affiliations: King's College London (GB)
University of Liverpool (GB)
Queen Mary University of London (GB)
Corresponding author: Whelan, Kevin
ORCID: Rossi, Megan
Aggio, Raphael
Staudacher, Heidi M.
Lomer, Miranda C.
Lindsay, James O.
Irving, Peter
Probert, Chris
Whelan, Kevin
Venue: Clinical Gastroenterology and Hepatology
Publisher: Elsevier BV
Published: 2018-03
Volume: 16
Issue: 3
Pages: 385-391.e1
ISSN: 1542-3565 (ISSN-L)
DOI: 10.1016/j.cgh.2017.09.055
OpenAlex: W2762056035
Cited by: 122
References: 32
Citations by year: 2026: 9 · 2025: 8 · 2024: 14 · 2023: 13 · 2022: 21 · 2021: 13 · 2020: 17 · 2019: 17 · 2018: 10
FWCI: 12.62
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Gastroenterology and Hepatology (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (publishedVersion, cc-by-nc-nd)
Own your potential (DEAKIN) (submittedVersion)
Figshare (submittedVersion, cc-by)
Funders: National Institute for Health and Care Research
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Physical Sciences › Engineering › Biomedical Engineering › Advanced Chemical Sensor Technologies
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords: irritable bowel syndrome, volatile organic compounds, low FODMAP diet, probiotics, treatment response biomarkers, wavelet transform, feature selection, non-invasive biomarkers, nutrition counseling, lactose
MeSH terms: Adult, Diet Therapy, Feces, Female, Humans, Male, Middle Aged, Placebos, Treatment Outcome, Probiotics, Irritable Bowel Syndrome, Volatile Organic Compounds

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Volatile Organic Compounds in Feces Associate With Response to Dietary Intervention in Patients With Irritable Bowel Syndrome

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