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Abstract
The differentiation between patients with irritable
bowel syndrome (IBS) and those with inflammatory bowel
disease (IBD) needs in most of cases the use of invasive
and expensive investigational techniques as endoscopic
examination and histological analysis of biopsy specimens
which are unpopular with patients.
The need for simple, non invasive diagnostic tools for
differentiation is of great importance.
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.
The present study aimed to reveal the diagnostic
value of faecal calprotectin in differentiating IBD from
IBS.
This study was conducted on 20 patients with IBD;
10 patients with active IBD (8 UC patients and 2 CD
patients) and 10 patients with inactive IBD (7 UC patients
and 3 CD patients) versus 20 patients with IBS diagnosed
Summary
201
according to Rome III criteria (10 IBS-D patients and 10
IBS-C patients) in addition to 10 healthy persons as control.
All patients were subjected to full history taking and
clinical examination, routine laboratory investigations, ESR
and CRP, stool culture and sensitivity, faecal calprotectin,
atypical p-ANCA and ASCA for the IBD group, abdominal
ultrasonography, colonoscopy and biopsy.
In this study, faecal calprotectin had a sensitivity,
specificity, PPV and NPV of 100%, 95%, 95.24% and
100% respectively when measured at 8.1 mg/L or above in
discriminating IBD from IBS patients, and these diagnostic
values were higher than that of CRP at its best cut off value
of 2.5 mg/L. However both faecal calprotectin and CRP
showed a 100% diagnostic accuracy in discriminating
active from inactive IBD at values of 25.5 mg/L and 5.5
mg/L respectively. Furthermore, faecal calprotectin
correlated significantly with the TLC, PLT count, ESR,
CRP and UC activity index.
In conclusion, faecal calprotectin appears to be a
clinically useful marker in differentiating IBD from IBS,
moreover it can be used as activity marker in IBD.