Detecting Intestinal Inflammation With Fecal Calprotectin Testing

Have you ever experienced recurring stomach pain accompanied by diarrhea or unexplained weight loss?

Some people consider these symptoms to be just a common digestive problem, perhaps due to spicy food or stress. However, in some cases, these symptoms may indicate inflammation of the intestines that requires monitoring.

It's not always easy to distinguish between common digestive issues and more serious conditions. This is where the fecal calprotectin test comes into play. This simple test uses a stool sample to detect inflammation in the digestive tract, enabling doctors to determine appropriate diagnostic steps and treatment.

What is fecal calprotectin?

A fecal calprotectin test measures the level of calprotectin, a protein that can indicate inflammation in the intestines, in stool. Typically, calprotectin is only present in small amounts. A high level indicates that the immune system is sending white blood cells, called neutrophils, to the inflamed area of the intestine. This inflammation can cause symptoms such as watery or bloody diarrhea, abdominal pain, and prolonged or recurring abdominal cramps.

Benefits of fecal calprotectin testing:

Fecal calprotectin testing is useful for determining the cause of gastrointestinal symptoms when a diagnosis is difficult to make based solely on symptoms or clinical examinations. This test distinguishes inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, which are organic conditions involving inflammation of the intestinal wall, from irritable bowel syndrome (IBS), which is a functional condition involving intestinal motility disorders.

While it cannot determine the exact cause of inflammation, test results are highly helpful for doctors when deciding on necessary further examinations, such as endoscopy or other laboratory tests.

In addition to the initial diagnosis, changes in fecal calprotectin levels can indicate mucosal healing or inflammation recurrence. This makes the test useful for monitoring IBD patients, identifying recurrence risks, and enabling timely intervention to prevent intestinal damage and long-term complications.

While fecal calprotectin is a highly sensitive marker of inflammation in the digestive tract, it is not specific to IBD. Elevated levels may also be found in gastrointestinal malignancies, infections, polyps, and NSAID use. Nevertheless, this test has clinical advantages over other inflammatory markers, such as plasma C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).

IBD vs IBS

Both IBD (inflammatory bowel disease) and IBS (irritable bowel syndrome) are chronic conditions that can affect adults and children alike. They have similar symptoms, such as diarrhea, abdominal pain, and cramps, which come and go. The main difference is that only IBD causes intestinal inflammation.

• IBD (inflammatory bowel disease) is a group of digestive diseases characterized by watery or bloody diarrhea. Examples of IBD include Crohn's disease and ulcerative colitis. Chronic inflammation can damage the intestinal lining and is believed to be associated with autoimmune and genetic factors.

  
  

• IBS, on the other hand, is a collection of symptoms, including bloating, pain, cramps, diarrhea, constipation, or a combination of these symptoms. There is no intestinal damage or inflammation, and the cause is believed to be related to communication disorders between the brain and intestines.

When should fecal calprotectin testing be performed?

Fecal calprotectin testing is generally recommended when a person experiences symptoms indicating inflammation of the digestive tract. This testing helps doctors distinguish between inflammatory bowel disease (IBD) and non-inflammatory bowel disorders.

IBD symptoms can vary from person to person and change over time, including:

• Bloody or watery diarrhea

• Abdominal cramps or pain

• Fever

• Weight loss

• Rectal bleeding

• Weakness

This test can also help determine if further examinations, such as an endoscopy (colonoscopy or sigmoidoscopy), are necessary. For patients who have already been diagnosed with inflammatory bowel disease (IBD), fecal calprotectin testing can be performed whenever there is suspicion of recurrence. This testing can confirm disease activity and assess its severity.

Is any preparation required before the fecal calprotectin test?

Ask your doctor before the test if you need to stop taking any medications. Never stop taking a medication without your doctor's approval.

Some medications can affect test results. These medications include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, are used to relieve pain.

• Proton pump inhibitors (PPIs), such as omeprazole, esomeprazole, and lansoprazole, are used to control stomach acid and treat GERD symptoms.

Overall, fecal calprotectin concentration testing is a safe, practical, and reliable noninvasive method of detecting intestinal wall inflammation. It helps distinguish inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS), monitor disease activity, assess the risk of recurrence, and evaluate mucosal healing. Additionally, it can help doctors determine the need for further testing, thereby reducing unnecessary endoscopic procedures. However, since the results are not specific to IBD, they must be interpreted in the context of the patient's overall clinical picture.

Source:

1.     Medlineplus.com – Calprotectin stool test

2.     NCBI – Faecal Calprotectin

3.     Testing.com – Calprotectin