CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(01): 001-006
DOI: 10.1055/s-0041-1739351
Original Article

Can Fecal Calprotectin Reflect Your Colonic Status?

Rasha Ibrahim Salama
1   Department of Tropical Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
,
2   Department of Hepatology, Gastroenterology, and Infectious Disease of the Faculty of Medicine at Kafrelsheikh University, Kafrelsheikh, Egypt
› Author Affiliations
Funding None.

Abstract

Background Organic colonic manifestation may be difficult to be differentiated from functional one. Inflammatory bowel disease (IBD) is a common chronic inflammatory and destructive disease of the bowel wall. Chronic inflammation is associated with ulcerations, strictures, perforations, and it is a risk factor for dysplasia and cancer. To reduce these long-standing complications, IBD patients are in a continuous need for early diagnosis[1]. Markers, such as erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP), fecal calprotectin (FC) have been widely used as noninvasive parameters for IBD monitoring. We aimed, in this current study, to evaluate the value of fecal calprotectin and other noninvasive biomarkers in predicting abnormal histologic findings in patients undergoing colonoscopy.in addition to determine the cutoff value which predict IBD[2].

Methods The present prospective study included 160 patients with complaint of colicky abdominal pain with frequent diarrhea associated with mucous and infrequent bleeding per rectum for more than 6 months. They presented partial improvement with medication and recurrence once stopping the treatment These patients had been recently diagnosed with IBD at many primary healthcare centers covering the areas of the Kafrelsheikh and Zagazik governorate in the North of Egyptian Nile delta. After complete history, clinical examination, and laboratory investigation, they were referred to the IBD clinic at Kafrelsheikh University Hospital for assessment and ileocolonoscopy with biopsies.

Results There was a wide spectrum of age of the studied patients, with mean age 40.12 ± 7.88 (minimum 18 and maximum 56 years). Regarding gender, males represented 87.5% of the studied patients. Forty percent of the patients with colonic manifestation were smokers, 57% preferred a spicy diet, and the majority had low educational level (77.5%). Forty percent had obvious blood in stool, 55% had occult blood, and raised ESR CRP occurred in 32.5% and 50%, respectively. Fecal calprotectin cutoff was > 159, with sensitivity 92.8% and specificity 97.5%.

Conclusions: Biomarkers (FC, ESR, CRP) can be used as noninvasive parameters for the early diagnosis and prediction of organic colonic disease. Fecal calprotectin in the IBD group revealed significant area under the curve (AUC) values and cutoff > 159, with sensitivity 92.8% and specificity 97.5%.

Ethics & Consents

The present study was performed in accordance with the Declaration of Helsinki, Good Clinical Practice, and applicable regulatory requirements. A written informed consent was obtained from all patients after explanation of the research idea.


Author Contribution

All authors contributed equally towards formulating the idea, conception, data collection, statistics, writing, and drafting of the manuscript.




Publication History

Received: 14 November 2020

Accepted: 15 June 2021

Article published online:
11 February 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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