Calprotectin in the stool (stool) is a substance that may indicate inflammation in the digestive system. Fecal calprotectin testing allows you to identify inflammatory bowel diseases and distinguish them from irritable bowel syndrome, and thus often avoid colonoscopy. What is fecal calprotectin testing? What are the standards for this test? What does increased calprotectin mean?

Calprotectinis a substance that appears in the body when it is inflamed.Calprotectinis even called an inflammation marker, that is, an inflammatory "detector". During inflammation, levels of calprotectin are increased in plasma, synovial fluid, urine, saliva, and also in faeces (stools). In the latter case, it may indicate inflammation of the digestive system.

Calprotectin - indications for the test

  • suspicion or monitoring of treatment of already diagnosed inflammatory bowel diseases - incl. Crohn's disease, ulcerative colitis, and therefore the appearance of symptoms such as:

- recurrent diarrhea (with blood and mucus) - abdominal pain - loss of appetite

The study is not reimbursed by the National He alth Fund. Its price is about PLN 150.

  • acute inflammation of the intestine
  • patients who underwent surgery to excise polyps of the large intestine
  • distinguish between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) or functional bowel disorders (these diseases have similar symptoms)
  • suspected inflammation in the mouth

The 2015 British NICE guidelines recommend the measurement of fecal calprotectin as a complementary test in the differential diagnosis of IBD and IBS in people with fresh-onset clinical symptoms who are not suspected of having a neoplastic process.

Calprotectin - what is the test?

The test involves the determination of calprotectin in a stool sample. The calprotectin level in the sample remains constant for up to 7 days. In addition, it does not fluctuate daily - one sample is enough to obtain a reliable result.

Important

Calprotectin - norms

  • <50 μg/g - mieści się w normie. Wynik w zakresie normy wyklucza proces zapalny w jelicie. Przyczyną dolegliwości prawdopodobnie jest zespół jelita drażliwego
  • 50-150 μg / g - weakly positive (patients should bemonitored, if necessary, the test can be repeated after 6-8 weeks)
  • >150 μg / g - indicates an active inflammatory process and requires a rapid extension of diagnostics (colonoscopy, X-ray contrast tests, further laboratory tests)

Increased calprotectin

In IBD patients, the intestinal barrier becomes unsealed and leukocytes penetrate the intestinal wall, which in turn leads to an increased release of calprotectin into the stool.

It should be remembered, however, that fecal calprotectin is not a marker specific only to inflammatory bowel diseases. Its concentration also increases in:

  • colorectal cancer
  • active rheumatic diseases
  • acute pancreatitis
  • cirrhosis of the liver
  • pneumonia
  • after considerable effort
  • while taking non-steroidal anti-inflammatory drugs (NSAIDs)

In turn, after intensive treatment with adrenal cortex hormones, its concentration decreases.

Worth knowing

Calprotectin - a test that allows you to avoid colonoscopy

Inflammatory bowel disease is a major diagnostic and therapeutic problem. Until recently, in diagnostics, a colonoscopic examination was ordered first, which is invasive. Calprotectin levels can be avoided. According to clinical trials, the sensitivity of tests in adults is 83-100%, and the specificity is 60-100%. In children, the sensitivity is 95-100%, while the specificity is 44-93%. So if calprotectin is normal, no colonoscopy is required. However, if the test shows that calprotectin levels are elevated, it may suggest inflammatory bowel disease. Then a colonoscopy is necessary, thanks to which a final diagnosis can be made.

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Research