ROLE OF FECAL CALPROTECTIN IN DIAGNOSING INFLAMMATORY BOWEL DISEASE AND IN DETECTING THE DISEASE ACTIVITY

Abstract

Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, is a chronic, idiopathic disease caused by a dysregulated immune response to host intestinal microflora and marked by recurrent episodes of inflammation in the gastrointestinal tract. Diagnosis of IBD is based on a combination of clinical history and examination, blood parameters, radiology and the gold standard to establish diagnosis remains the endoscopy and histopathology. Discriminating irritable bowel syndrome from inflammatory bowel disease is a common clinical challenge especially when both conditions share same symptoms. In order to avoid invasive investigations, several noninvasive markers have been evaluated for their capacity to distinguish between functional and organic inflammatory gastrointestinal disease. Faecal calprotectin is a sensitive marker for the detection of bowel inflammation. It is easy to measure, resistant to proteolysis, stable in stool for 7 days and not expensive. This current study aimed to clarify the role of fecal calprotectin in the diagnosis of inflammatory bowel disease and to identify the relation between the level of fecal calprotectin & the degree of activity and severity of inflammation in patients with inflammatory bowel disease. The present study was conducted on 40 patients with IBD; 20 patients with active IBD (16 patients UC and 4 patients CD) and 20 patients with inactive IBD (13 patients UC and 7 patients CD) versus 20 patients with IBS in addition to 20 healthy persons as control. All patients were subjected to full history taking, clinical examination, routine laboratory investigations, ESR and CRP, stool culture and sensitivity, abdominal ultrasound, fecal calprotectin, total colonoscopy with terminal ileum examination and biopsies with histopathological examination. To evaluate activity of inflammatory bowel disease, Mayo Score was used in ulcerative colitis and Crohn's Disease activity index beside the histopathology.