Department of Medicine, National University Hospital, Singapore, Singapore.
Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.
Neurogastroenterol Motil. 2023 Jul;35(7):e14536. doi: 10.1111/nmo.14536. Epub 2023 Feb 13.
Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disease characterized by intermittent abdominal pain with altered bowel habits. Due to the condition's chronicity, patients suffer from poor quality of life, while the healthcare burden continues to grow. There is currently no reliable biomarker for the diagnosis of IBS, and the current approach depends on ruling-out organic diseases such as inflammatory bowel disease (IBD) and colorectal cancer by markers of inflammation like fecal calprotectin and C-reactive protein, or invasive procedures like a colonoscopy. Volatile organic compounds (VOCs) are growing in popularity as a biomarker due to its accuracy and ease of use.
This systematic review of Medline and Cochrane's databases aimed to identify VOCs in the diagnosis of IBS. 57% of the studies proved that VOCs could identify IBS patients from healthy controls with AUC ranging from 0.83 to 0.99. Studies that distinguished IBS from IBD patients had slightly higher AUC of 0.87-0.98. Combining VOC into panels allowed the creation of discriminative algorithms. Though current research is limited by areas of heterogeneity in VOC sampling and small sample sizes, our review shows that VOC analysis has the potential to be a noninvasive point-of-care test that differentiates IBS from other organic gastrointestinal diseases.
肠易激综合征（IBS）是一种常见的胃肠道疾病，其特征为间歇性腹痛伴排便习惯改变。由于该病的慢性特征，患者生活质量较差，且医疗保健负担持续增加。目前，IBS 没有可靠的诊断生物标志物，当前的诊断方法依赖于通过粪便钙卫蛋白和 C 反应蛋白等炎症标志物或结肠镜等有创程序来排除炎症性肠病（IBD）和结直肠癌等器质性疾病。由于其准确性和易用性，挥发性有机化合物（VOC）作为生物标志物越来越受到关注。
本研究通过对 Medline 和 Cochrane 数据库的系统回顾，旨在确定用于诊断 IBS 的 VOC。57%的研究表明，VOC 可用于区分 IBS 患者和健康对照组，AUC 范围为 0.83 至 0.99。用于区分 IBS 和 IBD 患者的研究的 AUC 略高，为 0.87-0.98。将 VOC 组合成面板可创建具有区分能力的算法。尽管当前的研究受到 VOC 采样和样本量小等异质性领域的限制，但我们的综述表明，VOC 分析有可能成为一种非侵入性的即时护理测试，可区分 IBS 与其他器质性胃肠道疾病。
