Rational Use of Fecal Calprotectin in Irritable Bowel Syndrome and Inflammatory Bowel Disease

Roberto Catanzaro; Alfio Maugeri; Morena Sciuto; Fang He; Baskar Balakrishnan; Francesco Marotta

doi:10.18502/acta.v59i4.6217

Roberto Catanzaro Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy
Alfio Maugeri Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy
Morena Sciuto Department of Clinical and Experimental Medicine, Gastroenterology Section, Gaspare Rodolico Hospital, University of Catania, Catania, Italy
Fang He Department of Nutrition, West China School of Public Health, Sichuan University, Sichuan, China
Baskar Balakrishnan Department of Immunology, Mayo Clinic, Rochester, MN, USA
Francesco Marotta ReGenera R and D International for Aging Intervention and San Babila Clinic, Milano, Italy

DOI: https://doi.org/10.18502/acta.v59i4.6217

Keywords: Fecal calprotectin; Irritable bowel syndrome; Inflammatory bowel diseases; Ulcerative colitis; Crohn's disease

Abstract

The gastrointestinal pathologies have increased over the last years. The clinical pictures of inflammatory and irritable bowel disease might overlap, leading to expensive and invasive tests. Our study aims to investigate fecal calprotectin as an effective tool for differential diagnosis of gastrointestinal disorders. Two hundred fifty-six patients with the diagnosis of the gastrointestinal disorder and subjected to colonoscopy were collected for the statistical analysis of fecal calprotectin. The differential diagnosis of intestinal inflammation or non-inflammation was performed according to the Receiver Operating Characteristic (ROC) curve that outlines the Area Under Curve (AUC), Sensitivity (Se), Specificity (Sp). Fecal calprotectin was significantly elevated in patients with inflammatory bowel disease compared with patients with irritable bowel syndrome. Especially, the mean values of fecal calprotectin were 522 g/g (IQR=215-975) and 21 g/g (IQR=14-34.5) in patients with and without inflammation, respectively (P<0.0001). AUC value of fecal calprotectin was 0.958 (Se=88.9%, Sp=91.1%, with a cut-off value of 50 g/g) for differentiating between inflammatory bowel disease and irritable bowel syndrome. Fecal calprotectin seems to be a non-invasive and inexpensive biomarker useful for the purpose of a differential diagnosis between inflammatory bowel disease and irritable bowel syndrome.