Review article: breath analysis in inflammatory bowel diseases

Area of Science:

• Biochemistry
• Gastroenterology
• Medical Diagnostics

Background:

• Urgent need for specific, accessible biomarkers for inflammatory bowel disease (IBD) diagnosis and stratification.
• Volatile organic compounds (VOCs) in exhaled breath offer a non-invasive method for disease detection.

Purpose of the Study:

• To review and discuss literature on VOCs in exhaled breath for gastrointestinal (GI) disorders.
• Focus on the diagnosis and differentiation of IBD using breath analysis.

Main Methods:

• Systematic literature search of PubMed, Ovid Medline, and Scopus databases.
• Bibliography search of relevant articles was also performed.

Main Results:

• Elevated breath levels of pentane, ethane, propane, 1-octene, 3-methylhexane, 1-decene, and NO in IBD patients compared to controls.
• Decreased levels of 1-nonene, (E)-2-nonene, hydrogen sulphide, and methane in IBD patients.
• A panel of three VOCs (octene, (E)-2-nonene, decene) demonstrated high discrimination (AUC 0.96) between pediatric IBD and controls. Elevated breath condensate cytokines and correlation of certain VOCs with disease activity were observed.

Conclusions:

• Breath analysis is a promising, non-invasive tool for IBD diagnosis and monitoring.
• While not yet ready for routine clinical use, its feasibility is supported by data from other GI diseases.
• Future trials should focus on identifying specific breath metabolome patterns for IBD diagnosis and phenotyping.