What is Calprotectin?

Calprotectin is a protein found naturally in your body, specifically inside a type of white blood cell called a neutrophil. These cells are part of your immune system and rush to areas of inflammation or infection. When there is inflammation in the intestines, these neutrophils become active and release calprotectin. Therefore, the level of calprotectin in a stool sample directly correlates with the amount of inflammation in the gastrointestinal (GI) tract.

Why is the Test Done?

The primary reason for a calprotectin test is to help doctors distinguish between two major categories of gut problems:

1. Inflammatory Bowel Disease (IBD): This includes conditions like Crohn’s disease and ulcerative colitis, where the immune system mistakenly attacks the lining of the GI tract, causing chronic inflammation.
2. Irritable Bowel Syndrome (IBS): This is a functional disorder where the gut is sensitive and causes symptoms like cramping and bloating, but there is no visible inflammation or damage.

The symptoms of IBD and IBS—such as abdominal pain, persistent diarrhea, and bloating—can be very similar. The calprotectin test acts as a helpful “inflammatory marker” to point doctors in the right direction.

How is the Test Performed?

The test is remarkably simple and non-invasive. It requires only a small stool sample, which you collect at home using a special kit provided by your doctor or clinic. The sample is then sent to a laboratory for analysis. There, technicians measure the concentration of calprotectin in the stool, usually reported in micrograms per gram (µg/g).

What Do the Results Mean?

Normal/Low Level:A result within the normal range (often below 50 µg/g, but the exact threshold can vary by lab) strongly suggests that active inflammation in the intestines is unlikely. This supports a diagnosis of a non-inflammatory condition like IBS.
High Level: An elevated calprotectin level indicates that inflammation is present in the GI tract. This warrants further investigation to determine the cause. While it’s a strong indicator for IBD, high levels can also occur in other conditions like bacterial infections, colitis, or even colon cancer. Therefore, it is not a definitive diagnostic tool for a specific disease but a crucial guide.
For People with Known IBD: The test is also used to monitor patients already diagnosed with Crohn’s or colitis. Regularly checking calprotectin levels helps doctors assess if treatment is working, if the disease is in remission, or if a flare-up is starting, sometimes even before symptoms appear.

Benefits and Limitations

Benefits:
Non-invasive: No needles or scopes required for the initial screening.
Helpful Triage Tool: Effectively helps separate inflammatory from non-inflammatory conditions, reducing the need for unnecessary invasive procedures like colonoscopies for IBS patients.
Good for Monitoring:Provides an objective measure of inflammation over time.

Limitations:
Not Specific:It pinpoints inflammation but does not identify its exact cause or location.
Can Have False Positives:Elevated levels can be seen with NSAID use, certain gut infections, or in the elderly.
Follow-up Needed: A high result almost always requires further investigation, typically with endoscopic procedures like a colonoscopy to get a visual diagnosis and take biopsies.

Conclusion

In summary, the fecal calprotectin test is a valuable, patient-friendly tool in modern gastroenterology. It serves as an effective early screen to detect gut inflammation, helping to differentiate between IBD and IBS and guiding decisions about the need for more invasive tests. If you are experiencing persistent digestive symptoms, talk to your doctor about whether a calprotectin test could be a useful first step in your diagnostic journey.

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