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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 very important, 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 major 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 lining of the gastrointestinal tract and can reduce the need for colonoscopies and has a lower cost 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 the use of invasive colonoscopies and the use of 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 in many cases 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, a test that 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 removal of radioactive material) and also 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 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 of colon cancer clearly demonstrates the diagnostic superiority of the measurement of stool calprotectin. The parameter has a high diagnostic value: if the levels of stool calprotectin are low, the probability that there is no organic intestinal disease is high.

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

Diagnostiki Athinon was the 1st laboratory in Greece that introduce Stool Calprotectin measurement, since 2011!
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