Should we all be getting fecal calprotectin testing?

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Zizzle
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Should we all be getting fecal calprotectin testing?

Post by Zizzle »

This abstract makes me think simple stool testing could be a reliable way to determine how active our disease is. Perhaps it could eliminate more frequent colonoscopies too? Or verify our remission status? Seems like something Enterlab should be adding to their profiles. Or do they already?

Has anyone here ever had their fecal calprotectin level checked?

Fecal calprotectin in clinical practice: a noninvasive screening tool for patients with chronic diarrhea.
J Clin Gastroenterol. 2012; 46(6):504-8 (ISSN: 1539-2031)

Licata A; Randazzo C; Cappello M; Calvaruso V; Butera G; Florena AM; Peralta S; Cammà C; Craxì A
*Sezione e U.O.C. di Gastroenterologia, Di.Bi.M.I.S. †Sezione di Anatomia Patologica, Università di Palermo, Palermo, Italy.


BACKGROUND: : Surrogate markers of colorectal inflammation are increasingly being recognized as important in differentiating organic from functional intestinal disorders. Fecal calprotectin (FC) can be easily measured in the stool, being released by leukocytes in inflammatory conditions.

AIM: : We evaluated FC as an index of inflammation in consecutive outpatients referred for colonoscopy for chronic, nonbloody diarrhea.

METHODS: : Stool specimens of 346 outpatients with chronic, nonbloody diarrhea, referred for colonoscopy, were measured for FC levels. The proportion of patients correctly diagnosed with the test and the relationship with endoscopic and histologic findings were measured.

RESULTS: : Abnormal endoscopic findings were detected in 104 patients (30.1%). Histologic findings included 142 patients (41.0%) with inflammation and 204 (59.0%) without inflammation. Fecal excretion of calprotectin significantly correlated with the finding of inflammation at endoscopy and histology (P<0.0001). When 150 mcg/g of stool was used as the upper reference limit, FC showed 75.4% sensitivity and 88.3% specificity, with 81.7% positive and 83.7% negative predictive values for histologic inflammation.

CONCLUSIONS: : In outpatients referred for colonoscopy a measurement of FC is accurate to identify those with histologic inflammation. Assay of FC may be a reliable and noninvasive screening tool to identify inflammatory causes of chronic, nonbloody diarrhea.
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tex
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Post by tex »

That technology has been around for at least 12 years, and according to Wikipedia, it's commonly used to screen for IBDs.

http://www.ncbi.nlm.nih.gov/pubmed/11051356

And it's been reevaluated from time to time:

http://www.ncbi.nlm.nih.gov/pubmed/17324124

I don't really see the point of it, since anyone with inflammation will have symptoms and will show an elevated FC level, whereas anyone without significant inflammation will not have symptoms and will show a normal level. It merely confirms what you already know. :shrug:

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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