Nutritional and Metabolic Diseases Clinical Trial
Official title:
Evaluation of Gastrointestinal and Nutritional Diagnostic Tests as Potential Screening Tools for Metabolic Body Odor and Halitosis
This study is designed as a retrospective cohort study to evaluate the potential of diagnostic procedures in defining populations of patients self-reporting unexpected and uncontrollable episodes of body odor and/or halitosis. The cohort - generally healthy individuals who had underwent multiple diagnostic tests recommended by their physicians and had not been diagnosed with any known medical condition - expressed their interest in trying gastrointestinal and nutritional diagnostic tests offered by Biolab Medical Unit. Our retrospective analysis will determine if these tests were useful as potential screening tools for metabolic body odor and halitosis.
Many yet uncharacterized medical conditions including inborn and acquired errors of
metabolism or skewed microbiome could be responsible for unpredictable and uncontrollable
episodes of body odor and halitosis. These conditions have dramatic impact on the quality of
life and socioeconomic outcomes of sufferers. Yet clinics and specialized malodor centers do
not provide tests for diagnosing malodor other than trimethylaminuria (TMAU). Self-reported
odor problems are often dismissed if are not organoleptically evaluated by trained odor
judges that are not readily available during malodor flare-ups.
The aim of this study is to analyze effectiveness of existing gastrointestinal and
nutritional tests for the assessment and investigation of self-reported malodors.
Diagnostic tests included:
- Gut Permeability Profile. PEG 400 is used as a probe and measured in urine passed for
the following 6 hours at 11 different molecular weights to establish the quantity of
each absorbed through the gut wall. Extraction and separation of PEG from urine is done
by ion exchange chromatography and capillary GLC.
- Gut Fermentation Profile. Blood alcohols - ethanol, methanol, butanol, propanol and
short chain fatty acids - are measured by gas-liquid chromatography.
- D-lactate test. D-lactate is measured by centrifugal analysis using the specific enzyme
D-lactate dehydrogenase, which does not react with L-lactate
- The urine indicans (Obermeyer) test. Detection of indican in the urine depends upon its
decomposition and subsequent oxidation of indoxyl to indigo blue and its absorption into
a chloroform layer
- Breath test for small intestinal dysbiosis. Breath hydrogen and methane are measured by
gas-liquid chromatography. The patient is given 10 gm of lactulose in 200 ml of water
and alveolar air samples are collected every 20 minutes for 3 hours
- Functional B vitamins profile, by measuring the activation of a red cell enzyme that is
dependent upon an adequate concentration of a particular vitamin for full activity. The
assay relies on normal metabolism of the vitamin to its native form and the presence of
other non-vitamin cofactors.
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