Calprotectin Crohn's disease

Calprotectin in stool (feces) examination: alternative to internal bowel examination to rule out Crohn's disease.

If Crohn's disease or another chronic inflammatory bowel disease is suspected, stool samples can be used to diagnose Crohn's disease. Previously, this required an extensive bowel examination. The coloscopy (examination using an optical instrument) is now only necessary when there is a strong suspicion.

Read the full press release from VUmc dated April 4, 2017here.

According to the researchers, the new IS-pro technique is a fast technique that can be applied in every hospital and laboratory.

''The technique makes diagnosis simpler for doctors and for patients with suspected inflammatory bowel disease (IBD), an inflamed bowel. Instead of first doing a colonoscopy and a days-long bacterial culture, the general practitioner can now send a poop sample that can rule out the disease in almost nine out of ten times.''

''And only if a sample shows IBD does a patient go on for a colonoscopic examination'' says medical microbiologist Dr. Dries Budding.

Poop test

During the poop test, the composition of the bacteria in the intestine is checked. This composition is different in patients with chronic intestinal inflammation than in healthy people. According to the researchers, the new technique can ensure that patients with Crohn's disease or other chronic intestinal inflammation can start therapy in good time.

According to the researchers, the course of the diseases would also be better and easier to monitor, which is very important in chronic intestinal inflammation.

The result is good if it is below 50 μg/g.

The result of calprotectin may be incorrectly lowered in watery stools (dilution defect). The higher the inflammation the higher the result, because calprotectin is a reliable marker of inflammation. The result may be slightly lower in dilute stools, but is still significant.

Calprotectin results can be false positive due to intake of certain medications: some medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can increase levels of calprotectin in the stool.

Calprotectin in stool results from a calcium-binding protein complex of neutrophils and monocytes. It is a sensitive marker of inflammation as well as malignant intestinal diseases. This is particularly true in non-bleeding polyps in colon cancer.

In a large study (Langhorst J., et al, Am J Gastroenterol 2008 103 :. 162-169), Calprotectin was shown to have a sensitivity of 82% and specificity of 87% in distinguishing irritable bowel syndrome (PDS) from inflammatory bowel disease such as Crohn's disease.

This test is meant for diagnosis, not for monitoring. A result above 50 μg/g indicates inflammation. The test measures up to 1600.