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Application of a Novel Tool for Diagnosing Bile Acid Diarrhoea
School of Engineering, University of Warwick, Coventry CV4 7AL, UK
MOAC Doctoral Training Centre, University of Warwick, Coventry CV4 7AL, UK
Department of Gastroenterology, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK
Department of Nuclear Medicine, University Hospital Coventry & Warwickshire, Coventry CV2 2DX, UK
Department of Gastroenterology, Rotherham General Hospital, Rotherham S60 2UD, UK
Clinical Sciences Research Institute, University of Warwick, Coventry CV2 2DX, UK
* Author to whom correspondence should be addressed.
Received: 1 July 2013; in revised form: 2 September 2013 / Accepted: 2 September 2013 / Published: 6 September 2013
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.
Keywords: electronic nose; FAIMS; bile acid diarrhea (BAD); bile acid malabsoprtion (BAM); fermentome
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Covington, J.A.; Westenbrink, E.W.; Ouaret, N.; Harbord, R.; Bailey, C.; O'Connell, N.; Cullis, J.; Williams, N.; Nwokolo, C.U.; Bardhan, K.D.; Arasaradnam, R.P. Application of a Novel Tool for Diagnosing Bile Acid Diarrhoea. Sensors 2013, 13, 11899-11912.
Covington JA, Westenbrink EW, Ouaret N, Harbord R, Bailey C, O'Connell N, Cullis J, Williams N, Nwokolo CU, Bardhan KD, Arasaradnam RP. Application of a Novel Tool for Diagnosing Bile Acid Diarrhoea. Sensors. 2013; 13(9):11899-11912.
Covington, James A.; Westenbrink, Eric W.; Ouaret, Nathalie; Harbord, Ruth; Bailey, Catherine; O'Connell, Nicola; Cullis, James; Williams, Nigel; Nwokolo, Chuka U.; Bardhan, Karna D.; Arasaradnam, Ramesh P. 2013. "Application of a Novel Tool for Diagnosing Bile Acid Diarrhoea." Sensors 13, no. 9: 11899-11912.