Stool markers for Inflammatory Bowel Diseases

Q: Which "stool marker" can differentiate between inflammatory bowel disease (IBD) and any functional bowel disease? 


 Answer:  Calprotectin 

Calprotectin and lactoferrin are two stool markers for inflammatory bowel disease. Out of these two, calprotectin is the most used. If fecal calprotectin is normal, a diagnosis of inflammatory disease is practically ruled out. Also, if it is elevated, it has a sensitivity of about 93 percent and specificity of 96 percent to have IBD. Calprotectin is also used to monitor disease activity and flare-ups. 

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References:

1. Sipponen T. Diagnostics and prognostics of inflammatory bowel disease with fecal neutrophil-derived biomarkers calprotectin and lactoferrin. Dig Dis 2013; 31:336. 

2.  Mosli MH, Zou G, Garg SK, et al. C-Reactive Protein, Fecal Calprotectin, and Stool Lactoferrin for Detection of Endoscopic Activity in Symptomatic Inflammatory Bowel Disease Patients: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2015; 110:802. 

3.  Menees SB, Powell C, Kurlander J, et al. A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol 2015; 110:444. 

4. van Rheenen PF, Van de Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ 2010; 341:c3369.