Fecal Profiling Could Personalize Diets with Irritable Bowel

Fecal profiling of volatile organic compounds (VOC) may predict response to dietary interventions in patients with irritable bowel syndrome (IBS), according to a study published in the March issue of Clinical Gastroenterology and Hepatology. The authors say that VOC profiling is a low-cost, noninvasive tool that may enable personalized treatment options for IBS patients.

While gut microbiota may be related to pathogenesis and severity of IBS, microbiota is currently an unrealistic diagnostic target or marker of treatment outcome in practice because of the costs of its measurement, the authors say. However, some evidence shows that the fecal metabolome can provide insight into the pathophysiology of IBS.

In this study, 93 patients were randomized to both a diet intervention (sham or a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols

diet [LFD]) and supplement (placebo or probiotic). Fecal samples were collected at baseline and end of the 4-week study period. VOCs were analyzed using gas chromatography.

The researchers found that VOC patterns showed clear separation between

responders and non-responders to both LFD and probiotic at both baseline and end-of-treatment. There were 15 features in the VOC profiles at baseline that predicted

response to the low-FODMAP diet with a mean accuracy of 97 percent. At baseline, there were 10 features that classified response to probiotic with a mean accuracy of 89 percent. Results were similar with end-of-treatment analysis.

"In addition to the predictive nature of the baseline VOC patterns, the end-of-treatment models may provide additional insight into the pathophysiology of symptom generation and mechanisms underpinning dietary intervention, write the authors led by Megan Rossi, from King's College London (United Kingdom).

Takeaway: Fecal profiling of VOCs is a low-cost, noninvasive tool that may enable personalization of dietary treatment options for IBS patients.