With most diseases, an early diagnosis means a better prognosis, but sometimes it’s difficult, painful and expensive to test for illnesses. Now there’s a new way to spot a variety of conditions and all it takes is a simple breath.
You inhale….and you exhale…
Every minute, the average person takes about 15 breaths and researchers at the Cleveland Clinic say those breaths can reveal a lot about your health.
“Anything in your blood that is potentially volatile will end up in your breath.” Dr. Raed Dweik, MD, Director of the Pulmonary Vascular Program at the Cleveland Clinic told Ivanhoe.
Researchers have been studying whether a simple breath test could detect conditions like liver, kidney and heart disease. In a recent pilot study they were able to show the test was 100 percent accurate at identifying patients with heart failure.
“We were so surprised by it that we actually did it twice!” Dr. Dweik said.
They duplicated the results in the second trial. The test has also been able to detect patients with acute alcoholic hepatitis, a condition that has no diagnostic test.
“With more than a 90 percent accuracy, we could pick these patients every time we tested them.” Dr. Dweik explained.
Lung cancer is another disease picked up by the breath test. Previous studies have shown around 80 percent accuracy, but at the 2013 chest conference, Dr. Peter Mazzone reported on an advanced version of the sensor.
“The early results suggest that we’ve been able to improve our accuracy.” Dr. Mazzone told Ivanhoe.
Offering patients a simple, pain-free glimpse into their health.
Doctors hope the test will be able to detect other cancers in the future. A study testing the breath test on kidney disease patients is ending and doctors say the results will be published soon.
BREATH TESTING: By simply testing one’s breath, a multitude of health problems can be diagnosed. For centuries, doctors have noticed that disorders with the kidneys and liver have added a unique smell to the breath. Today, these tests are being expanded upon to help find asthma, diabetes and tuberculosis. Breath tests are also easier to administer than other tests. Compared to blood tests, a breath test is less expensive, yields results in a mere fraction of the time and can be repeated as much as necessary. Much like a finger print, each individual carries with them their own unique breath signature. When the breath is exhaled, tiny droplets of proteins, antibodies and DNA are sent out that contain an array of health information. (Source: Melinda Beck, www.online.wsj.com)
* Hydrogen Breath Test – This test is mainly used to detect lactose intolerance and bacterial overgrowth. It’s performed in the doctor’s office where the patient is asked to ingest milk, soda, or sugar water. When the patient exhales into the Breathalyzer, the doctor’s will analyze how much hydrogen is carried in the breath.
* Urea Breath Test – This test is simpler to perform compared to the hydrogen breath test. This test detects Helicobacter Pylori, which is a bacteria found in the stomach, which can lead to the development of ulcers. The test around 30 minutes to complete and typically yields results in about two to three days. (Source: www.austingastro.com)
NEW FINDING: Over the past few years, there’s been an increased use of breath tests to detect different liver and kidney disorders, stomach problems and various other health issues. But now a new type of breath test is being tested that’s not only able to detect diseases with the kidney and liver, but heart disease and lung cancer as well. This new test works by using a sensor that will change color based on which chemicals are being exhaled from the breath. Testing has shown that people suffering with heart disease have a distinctive breath pattern from the people who don’t. (Source: Peter Mazzone, MD)
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Raed Dweik, M.D., Director of the Pulmonary Vascular Program at the Cleveland Clinic talks about how a simple breath test could detect disease.
Tell us about breath testing and how it’s been developed for other conditions such as heart failure, kidney disease and liver failure.
Dr. Dweik: Yes, we’ve been doing breath testing for many years now and mainly at the beginning we were focused on the lung like things such as asthma and lung cancer, but more recently we’ve started looking at diseasees beyond the lungs and every place we look seems like we’re finding something. We looked for certain diseases we call the low hanging fruit, like diseases that have breath that’s different than someone with liver disease, for example, you know their breath is different; kidney disease is the same. What surprised us also is that people who don’t have distinctive breath for the human nose also have a distinctive breath when analyzed with our machines, so that’s exciting.
That’s interesting. How accurate has the testing been for heart failure, kidney disease and liver failure?
Dr. Dweik: It depends on the disease of course. We work with specialists in those areas, so they kind of tell us what direct questions to ask and what direct testing and what direct patient cohort to do. Heart failure was one of the earliest ones we did and we were quite surprised by it because this is one of those diseases that we did not expect to find a difference. When we looked at their breath and analyzed it, it was very striking to us that patients who come to the hospital with acute decompensated heart failure have breath that is quite different from people who don’t have heart failure, even though they have other heart diseases. That particular test is a small study; a pilot study, but it was 100% accurate which is not true for any test in the world, but that’s how it turned out in this particular test and we were so surprised by it that we actually did it twice. We did it in a testing cohort and then in a validation cohort and in both of them we could tell with 100% accuracy whether they have heart failure or not. It was pleasantly surprising to us and the results were very good.
What about the others, the kidney disease and liver failure?
Dr. Dweik: The kidney disease is still in progress, but the liver failure is another fascinating one. We expected to find differences there, but we didn’t expect it to be to a specific disease. We looked at different liver diseases like cirrhosis and fatty liver disease and one particular disease that stood out is acute alcoholic hepatitis. This is a very bad disease that has a very high rate of mortality and patients are very sick and currently there is no test to diagnose it. While there’s clearly a different signature for patients with liver disease in general, patients with acute alcoholic hepatitis had a distinctive breath print that we could, with more than 90% accuracy, pick out in these patients every time we tested them. That’s very rewarding because it’s really very accurate and we can do it with detecting two or three compounds of the breath which is also very good.
Where do things stand with the kidney disease?
Dr. Dweik: The kidney is next on our list. We’ve been working on it and we’re looking at different aspects. There is a lot of good data there. It’s not published yet, so stay tuned. We’ll get you some more information about it soon.
What other diseases might the breath test be able to detect in the future?
Dr. Dweik: It’s interesting that even now, before we move to the future, we’ve looked at other situations. More recently we worked with our pediatric colleagues and looked at patients, obese kids for example, and to our surprise, patients who are obese have different breath prints than people who are not and once again, we could tell with more than a 90 percent degree of accuracy. We are following up on that to see if diet interventions make any difference. It will be interesting to look, not just at disease, but also state of health, like weight and response to diet or exercise, whether breath can detect any differences in those interventions.
What other types of diagnostic tools are on the horizon that are showing promise?
Dr. Dweik: Sometimes people ask me how the breath testing fits in everything else and I think it depends on how you use it. People are used to going to their physician and getting a blood test or an x-ray or urine test. Breath testing is something that’s kind of coming up and becoming more and more recognized. Sometimes, it will be the first test you do. We call it a screening test. If the breath test is positive, then you do more testing; if the breath test is negative, you say okay, there is nothing else to do, see you next year Mr. So and So. Another way to do it is more of a confirmatory test. You do some preliminary testing and get an x-ray, for example, that’s abnormal or a liver test that’s abnormal and you can say okay, let’s do a breath test to confirm or to see what type of liver problem you have or what type of heart problem you have. I think it depends on the disease where the breath test would fit; sometimes as a screening test, sometimes as a confirming test
Anything else you’d like to add?
Dr. Dweik: I think the interesting thing is that the more we look in the breath, the more we find. Initially, I was surprised by that but now the more I’m doing it, I recognize that it’s not surprising. Now, I think of the breath as the head space of the blood. Your blood goes through your lungs all the time, so anything in your blood that is potentially volatile will end up showing up in your breath. I like to think of it more as a blood test. There are blood tests for different kinds of diseases and the same thing with the breath; there would be breath tests for different kind of diseases, so we’re looking forward to having more and more of those.
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