Faecal volatile organic compounds differ according to inflammatory bowel disease sub-type, severity, and response to treatment in paediatric patients

United European Gastroenterol J. 2024 Jul;12(6):780-792. doi: 10.1002/ueg2.12603. Epub 2024 Jun 22.

Abstract

Background: Faecal volatile organic compounds (VOCs) differ with disease sub-type and activity in adults with established inflammatory bowel disease (IBD) taking therapy.

Objective: To describe patterns of faecal VOCs in children newly presented with IBD according to disease sub-type, severity, and response to treatment.

Methods: Children presenting with suspected IBD were recruited from three UK hospitals. Children in whom IBD was diagnosed were matched with a non-IBD child for age, sex, and recruitment site. Faecal VOCs were characterised by gas chromatography-mass spectrometry at presentation and 3 months later in children with IBD.

Results: In 132 case/control pairs, median (inter-quartile range) age in IBD was 13.3 years (10.2-14.7) and 38.6% were female. Compared with controls, the mean abundance of 27/62 (43.6%) faecal VOCs was statistically significantly decreased in Crohn's disease (CD), ulcerative colitis (UC) or both especially amongst ketones/diketones, fatty acids, and alcohols (p < 0.05). Short-chain, medium chain, and branched chain fatty acids were markedly reduced in severe colitis (p < 0.05). Despite clinical improvement in many children with IBD, the number and abundance of almost all VOCs did not increase following treatment, suggesting persistent dysbiosis. Oct-1-en-3-ol was increased in CD (p = 0.001) and UC (p = 0.012) compared with controls and decreased following treatment in UC (p = 0.01). In CD, propan-1-ol was significantly greater than controls (p < 0.001) and extensive colitis (p = 0.001) and fell with treatment (p = 0.05). Phenol was significantly greater in CD (p < 0.001) and fell with treatment in both CD (p = 0.02) and UC (p = 0.01).

Conclusion: Characterisation of faecal VOCs in an inception cohort of children with IBD reveals patterns associated with diagnosis, disease activity, and extent. Further work should investigate the relationship between VOCs and the microbiome in IBD and their role in diagnosis and disease monitoring.

Keywords: Crohn's disease; GC/MS; IBD; VOCs; children; faecal volatile organic compounds; gas chromatography–mass spectrometry; ulcerative colitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Colitis, Ulcerative* / diagnosis
  • Colitis, Ulcerative* / drug therapy
  • Colitis, Ulcerative* / therapy
  • Crohn Disease* / diagnosis
  • Crohn Disease* / drug therapy
  • Crohn Disease* / therapy
  • Feces* / chemistry
  • Feces* / microbiology
  • Female
  • Gas Chromatography-Mass Spectrometry
  • Humans
  • Inflammatory Bowel Diseases / diagnosis
  • Inflammatory Bowel Diseases / drug therapy
  • Male
  • Severity of Illness Index*
  • Treatment Outcome
  • United Kingdom
  • Volatile Organic Compounds* / analysis

Substances

  • Volatile Organic Compounds