CALPROTECTIN

Introduction

Calprotectin is an inflammatory marker that can show if your intestines are inflamed. Using fecal calprotectin helps differentiate between Inflammatory Bowel Disease and Irritble Bowel Syndrome and help prevent significant delays in getting the right diagnosis and management plan for your condition.

Similarities and Differences Between IBD and IBS

The symptoms between Inflammatory Bowel Disease (IBD) and Irritable Bowel Syndrome (IBS) are similar. They both can have diarrhoea or constipation, bloating, belly pain and feeling like one needs to go to toilet frequently.

However, IBD can also have blood in stools, weight loss, inflammation of skin, eyes or joints.

A lot of time and money can be spent in the process of making an accurate diagnosis between the two.

IBS affects 1 in 7 New Zealanders. 

IBD on the other hand is prevalent in around 20000 New Zealanders. 

However, it seems that upto 40% of IBD patients may have IBS type symptoms.

Why Choose To Test Fecal Protectin?

Calprotectin is a protein marker for inflammation of small intestine. Instead of spending a lot of time and money on treating IBS, a calprotectin test can help either eliminate or help towards diagnosis of inflammatory bowel disease (IBD) such as Crohn's Disease or Ulcerative Colitis.

Crohn's Disease can cause pain on the lower right side of your belly. Ulcerative Colitis can have pain on the lower left side of your belly. However, with IBS, the pain can be lower part of your belly.

An diagnosed and untreated IBD can lead to many problems such as:

- malnutrition

-anemia

- blood clots

- higher risk of colon cancer

- blocked bowels

- ulcers

- holes in the bowel.

The NICE guidelines (used as a standard of practice in UK) recommends that a calprotectin test is done before referral is made to a gastroenterologist. 

They summarise the following reasons why this should be done:

1. Many people with IBS have unnecessary investigations done to them before IBS is diagonosed. A calprotectin test can offer potential for better management.

2. There can be significant delays in diagnosing IBD and thus using faecal calprotectin can hurry the process so that people with IBD are referred appropriately to a gastroenterologist.

A negative test can potentially save unwanted investigations, time and resources. A high level of Calprotectin is an indicator of possibility of an inflammatory bowel disease. 

Confirmation needs to be made by a gasteroenterologist using further investigations such as coloscopy or a scan.

Reference

Faecal calprotectin diagnostic tests for inflammatory diseases of the bowel. Diagnostics guidance [DG11]Published: 02 October 2013. https://www.nice.org.uk/guidance/dg11