title: Application of a novel tool for diagnosing bile acid diarrhoea.
abstract: Bile acid diarrhoea (BAD) is a common disease that requires expensive imaging to diagnose. We have tested the efficacy of a new method to identify BAD, based on the detection of differences in volatile organic compounds (VOC) in urine headspace of BAD vs. ulcerative colitis and healthy controls. A total of 110 patients were recruited; 23 with BAD, 42 with ulcerative colitis (UC) and 45 controls. Patients with BAD also received standard imaging (Se75HCAT) for confirmation. Urine samples were collected and the headspace analysed using an AlphaMOS Fox 4000 electronic nose in combination with an Owlstone Lonestar Field Asymmetric Ion Mobility Spectrometer (FAIMS). A subset was also tested by gas chromatography, mass spectrometry (GCMS). Linear Discriminant Analysis (LDA) was used to explore both the electronic nose and FAIMS data. LDA showed statistical differences between the groups, with reclassification success rates (using an n-1 approach) at typically 83%. GCMS experiments confirmed these results and showed that patients with BAD had two chemical compounds, 2-propanol and acetamide, that were either not present or were in much reduced quantities in the ulcerative colitis and control samples. We believe that this work may lead to a new tool to diagnose BAD, which is cheaper, quicker and easier that current methods.
authors.affiliation: School of Engineering, University of Warwick, Coventry, UK. J.A.Covington@warwick.ac.uk
authors.forename: James A
authors.initials: JA
authors.lastname: Covington
authors.forename: Eric W
authors.initials: EW
authors.lastname: Westenbrink
authors.forename: Nathalie
authors.initials: N
authors.lastname: Ouaret
authors.forename: Ruth
authors.initials: R
authors.lastname: Harbord
authors.forename: Catherine
authors.initials: C
authors.lastname: Bailey
authors.forename: Nicola
authors.initials: N
authors.lastname: O'Connell
authors.forename: James
authors.initials: J
authors.lastname: Cullis
authors.forename: Nigel
authors.initials: N
authors.lastname: Williams
authors.forename: Chuka U
authors.initials: CU
authors.lastname: Nwokolo
authors.forename: Karna D
authors.initials: KD
authors.lastname: Bardhan
authors.forename: Ramesh P
authors.initials: RP
authors.lastname: Arasaradnam
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D001647:Bile Acids and Salts / Q000378:metabolism* / Q000652:urine; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000652:urine*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003967:Diarrhea / Q000175:diagnosis* / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D045602:Steatorrhea / Q000175:diagnosis* / Q000652:urine*; D055549:Volatile Organic Compounds / Q000652:urine*
chemical_list: D001647:Bile Acids and Salts; D055549:Volatile Organic Compounds
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