Differential diagnosis between organic inflammatory
intestinal diseases and functional irritable bowel syndrome
A quantitative test, Fecal Calprotectin (FC), is performed in the EMC Clinical diagnostic laboratory.
FC is a highly sensitive biomarker of intestinal inflammation.
The test is of great importance in the differential diagnosis of such common organic inflammatory bowel diseases as
Crohn's disease and ulcerative colitis, and functional disorders in the intestinal tract (irritable bowel syndrome).
Calprotectin reflects the migration of neutrophils through the intestinal wall.Its concentration increases significantly in ulcerative colitis and Crohn's disease.
Fecal calprotectin is stable in feces, which allows you to increase the time period from sampling to its examination to 7 days.
FC is the most important prognostic marker of clinical recurrence for Crohn's disease and ulcerative colitis and a noninvasive method of treatment control.
Other aspects of the clinical interpretation of FC levels in feces:
High concentrations of FC are detected in patients with bacterial infections of the gastrointestinal tract. But its level does not increase significantly in inflammatory diseases of the upper gastrointestinal tract (gastritis, duodenitis, peptic ulcer of the stomach and duodenum), as well as in patients with colorectal polyps, diverticulosis and adenoma of the large intestine.
At the same time, elevated FC values can be detected in colorectal neoplasia.
The concentration of FC does not change or may be only slightly increased in celiac disease.
The concentration of FC is high in newborns and children under 1 year of age.Therefore, the definition of FC should be used with caution in children under four years of age. At the same time, in children older than this age, FC testing can help identify ulcerative colitis and Crohn's disease during the latent period.
The results of the analysis may be influenced by some NSAIDs, drugs rich in zinc, magnesium, and calcium.
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The concentration of FC below 50 micrograms/ g indicates the absence of inflammatory processes in the intestine.
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The level of FC from 50 to 200 micrograms / g indicates the presence of an inflammatory process in the intestine. In case of initial detection, repeated analysis is recommended.
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The FC level above 200 mcg/g indicates an actively developing inflammatory process.
The differential diagnosis between ulcerative colitis and Crohn's disease is performed using detection of antibodies to SaccharomysescerevisiaeASCA (Service code 201). Their specificity for Crohn's disease is 95-100%.
You can take a sample for fecal calprotectin, as well as blood for ASCA antibodies, around the clock at any of the EMC clinics.