Sniffing Out Paediatric Gastro-intestinal Diseases: the Potential of Volatile Organic Compounds as Biomarkers for Disease.

The diagnostic work-up and follow-up of paediatric functional gastrointestinal disorders and organicconditions usually includes invasive tests, carrying a high burden on patients. There is a place, therefore, for novel, noninvasive disease-specific biomarkers. Volatile organic compounds (VOCs), originating from (patho)physiological metabolic processes in the human body, are excreted as waste products through all conceivable bodily excrements. The spectrum of VOCs harbours a magnificent source of information, with the potential to serve as noninvasive diagnostic biomarkers and to monitor disease activity. VOC analysishas been studied in children and infants with a variety ofgastro-intestinal diseases, including inflammatory bowel disease, liver diseases, irritable bowel syndrome, necrotising enterocolitis and infectious diarrhoea. Most of these studies, although limited in sample size, show that patients can be discriminated from controls based on their VOC profiles, underscoring the potential of VOC analysis in diagnosis and follow-up. Currently, however, the application of VOC analysis in clinical practice is limited; substantial challenges, including methodological, biological and analytical problems, still need to be met. In this review we provide an overview of the available literature on the potential of VOCs as biomarkers for paediatric gastro-intestinal diseases. We discuss the available techniques to analyse VOCs and provide topics for VOC-related research which need to be addressed before VOC diagnostics can be implemented in daily clinical practice. (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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