Journal of Gastrointestinal & Digestive System
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The Diagnosis of inflammatory bowel disease (IBD) requires extensive and often invasive investigations including
colonoscopy and histology and places a heavy burden, both on healthcare resources, because of the cost, and on the
individual, in times of disease-related disability and poor quality of life. Recently, there has been increasing interest in noninvasive
biomarkers to diagnose IBD and to monitor the disease activity. There is growing scientific interest in the investigation
of volatile metabolites and numbers of studies have focused on the utilization of non-invasive biomarkers in the diagnosis of
GI disease. The development of sophisticated analytical techniques has enabled the study and interpretation of changes in the
faecal and breath volatile organic metabolites (VOMs) and its correlation with the pathophysiological mechanisms in IBD.
VOMs are the chemicals that are the products and intermediates of metabolism and may be altered during the diseases process.
Changes in the signature of VOMs could potentially provide diagnostic information about health and disease. Multiple studies
have reported the differences in VOM profiles of healthy controls vs. patients with IBD other GI disorders. VOM profiles
have been used to segregate patients by disease activity and the type of disease. The correlation of VOMs with Microbiota is
interesting and supports the hypothesis of gut microbial dysbiosis in the etiology of IBD. This provides an important platform
to explore the role of dysbiosis in IBD and other GI disorders pathogenesis and development of novel therapeutic targets. In
future, further understanding of faecal VOMs may lead to the development of a rapid and simple point of care diagnosis and
monitoring of IBD.
1. Ahmed I, Niaz Z, Ewbank F, Ankarca D, Furnari M. Sniffing out causes of gastrointestinal disorder- A Review.
European Journal of gastrointestinal and Liver disease. (In press)
2. Hakizimana A, Ahmed I, Russell R, Wright M, Afzal NA. Challenges of modern day transition care in inflammatory
bowel disease: From inflammatory bowel disease to biosimilars. World Journal of Gastroenterology. 2017;23(25):4473-
3. Razanskaite V, Bettey M, Downey L, Wright J, Callaghan J, Rush M, Whiteoak S, Ker S, Perry K, Underhill C, Efrem
E, Ahmed I, Cummings F. Biosimilar Infliximab in Inflammatory Bowel Disease: Outcomes of a Managed Switching
Programme. J Crohns Colitis. 2017 Jun 1;11(6):690-696
4. Furnari M, Ahmed I, Erpecum KJ, Savarino V, Giannini EG. Breath Tests to Assess Alcoholic Liver Disease. Rev
Recent Clin Trials. 2016;11(3):185-90
5. Ahmed I, Greenwood R, Costello B, Ratcliffe N, Probert C. Letter: faecal volatile organic metabolites, promising
biomarkers in inflammatory bowel disease and Letter: faecal volatile organic metabolites as novel diagnostic
biomarkers in inflammatory bowel disease. Authors' reply. Aliment Pharmacol Ther. 2016 Jun; 43(11):1241-2.
Iftikhar Ahmed is a consultant gastroenterologist at University Hospital Southampton NHS Foundation Trust and visiting consultant at East Sussex Hospitals NHS foundation trust Eastbourne. He is also a Hon. Senior clinical lecturer at the University of Southampton UK. His research interests include investigating the changes in the smell of faeces and breathe in order to understand the pathophysiological mechanisms of GI disorders and to develop a non-invasive biomarker. Through formal laboratory research, He studied the faecal volatile metabolomics profiles of patients with Liver disease ( NAFLD) , IBD and irritable bowel syndrome (IBS) in comparison with healthy individuals, and was awarded the degree of Doctorate of Medicine (MD) by University of the Bristol in 2012. He has collaborative research experience with international colleagues, presented his work at both national and international conferences, and was awarded travel grants and prizes for the best abstracts and oral presentations on various occasions. He is on the reviewer panel of several national and international journals, including Gut, PLOS One, Journal of Gastrointestinal and Liver Disease and BMJ.