Children with IBD often have to undergo frequent blood monitoring to ensure optimal treatment and to assess for signs of relapse. This can be an anxious and difficult part of their care for both the child and their parents, other methods of obtaining useful clinical markers have been devised such as faecal calprotectin in stool. However, stool samples can be difficult to obtain and can be embarrassing for children. Another method which has been suggested is to measure inflammatory markers in breath which has already been used as a research tool in childhood asthma, a so called inflammatory disease of the airways. It is a simple non-invasive method which is more acceptable. This study compared children with IBD, children with asthma and normal children and measured various inflammatory markers in breath to assess the possible utility in IBD for detection of relapse. Unfortunately some of the markers they tested were not significantly different between the groups and the FNEO (a marker of asthma activity) which was measured in children with IBD did not correlate with disease activity or serum markers of inflammation. However, a lower ph was seen in children with IBD compared to controls and children with asthma but did not correlate with serum makers of inflammation such as ESR and CRP.
The concept of breath testing to detect relapse in IBD is attractive, quick, easy and more acceptable for children. However, based on the results of this study it seems unlikely this will provide any clinical benefit for some time.