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Calprotectin, Stool

Stool calprotectin is a reliable marker for the differentiation of irritable bowel syndrome (spastic colitis, IBS) from inflammatory bowel disease (Crohn's disease and ulcerative colitis, IBD). The difference between the two conditions is significant, as they often cause similar symptoms such as abdominal pain and cramps, diarrhea, and bloating, making the diagnosis based on clinical criteria only very difficult.

Both IBS and IBD are thought to be caused by intestinal dysbiosis, infections, toxic substances (drugs, food, allergens), and stress, with genetic predisposition playing a significant role in IBD. Because tissue damage in patients with inflammatory bowel disease poses a greater risk of developing colon cancer, accurate detection and diagnosis of these diseases are critical.

What are the advantages of measuring Calprotectin?

Although colonoscopy is the reference method for evaluating inflammatory bowel disease and the course of mucosal healing, it remains an invasive procedure that sometimes involves risks and complications while causing discomfort (in most patients), is time-consuming, and is relatively expensive. Measuring calprotectin in the stool is an easy, reliable, non-invasive method of detecting inflammation of the gastrointestinal tract's lining. It can reduce the need for colonoscopies and is cheaper compared to colonoscopies.

Measurement of Calprotectin in feces:

  • Differentiates the organic lesions of the intestine from the functional disorders
  • Determines the severity of inflammation of the intestinal mucosa
  • May assess inflammatory activity in patients with IBD and predict clinical relapses
  • Evaluates the response to treatment
  • Predicts the postoperative recurrence of patients with IBD

Therapeutic interventions guided by the measurement of stool calprotectin may reduce invasive colonoscopies and use more effective treatment regimens in patients with irritable bowel syndrome.

More information

Calprotectin is a protein that binds calcium and is mainly secreted by neutrophils and monocytes. Measurement of calprotectin in the stool is an indicator of neoplastic and inflammatory diseases of the gastrointestinal tract.

It is often difficult to distinguish between irritable bowel syndrome and chronic inflammatory bowel disease. This usually leads to extensive and invasive examinations, such as colonoscopy. The measurement of stool calprotectin allows a clear differentiation between the two groups of patients. There is a strong correlation between fecal calprotectin levels with histologic and endoscopic findings of Crohn's disease and ulcerative colitis activity, as well as fecal excretion of indium-111-labeled neutrophils. This test has been proposed as a reference method for the assessment of the activity of inflammatory bowel diseases. However, measuring indium-111-labeled neutrophils is very expensive (patient care, analysis, and radioactive material removal) and exposes patients to radiation. For this reason, the application of this method in children and pregnant women is not recommended.

Another advantage of measuring stool calprotectin is that elevated calprotectin levels have a much better prognostic value for the recurrence of inflammatory bowel disease than standard inflammatory markers (CRP, ESR).

Comparing calprotectin with the detection of blood in the stool (fecal hemoglobin) as the screening test for colon cancer clearly demonstrates the diagnostic superiority of measuring stool calprotectin. The parameter has a high diagnostic value: if stool calprotectin levels are low, there is a high probability of no organic intestinal disease.

Diagnostiki Athinon recently introduced a newer pyruvate kinase M2 (M2-PK) biomarker to detect colon tumors (cancer and polyps).

Diagnostiki Athinon was the 1st laboratory in Greece that introduced Stool Calprotectin measurement in 2011!
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