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Do I Have IBS?
Published in Melissa G. Hunt, Aaron T. Beck, Reclaim Your Life From IBS, 2022
Melissa G. Hunt, Aaron T. Beck
To diagnose Crohn’s disease, your doctor will check for a number of things. Using blood tests, they will check your complete blood cell count (CBC), sedimentation rate, and C-reactive protein, all of which might reveal underlying inflammation. They will also check your hemoglobin and vitamin B12 levels. Some people with Crohn’s will show signs of anemia, which can suggest that ulcers in the intestines are causing bleeding and/or that they are not absorbing sufficient iron from their food. B12 deficiencies are also common because B12 is absorbed by the ileum (the last section of the small intestine) which is a very common location for Crohn’s inflammation. In addition to blood work, the doctor will probably also ask you to take small stool samples for several days, and will check those samples for blood (called a fecal occult blood test), which can also suggest bleeding in the intestines. He or she will probably also order a fecal calprotectin test, which can be done with a larger stool sample. Calprotectin is a marker of inflammation specifically in the intestines. It’s very sensitive and can be used both diagnostically (to distinguish an IBD from IBS) and to track disease severity in an IBD.
Managing Pain in the Presence of Autoimmune Disease
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Inflammation markers calprotectin, EPX and Sig A are tested. Elevation of calprotectin indicates inflammation and that the patient is moving towards colon cancer and the ADs, such as ulcerative colitis and Crohn’s disease.103 If this number hasn’t normalized by the first recheck, a person needs to be referred for colonoscopy. An elevated EPX means some of the foods that are being consumed by the person are having a negative impact on the gut.104,105 High Sig A means intestinal permeability issues. A low Sig A means that the person has lost the protective mucosal membrane separating the intestinal wall from the contents of the gut.104,105
Common gastrointestinal investigations and psychological concerns
Published in Simon R. Knowles, Laurie Keefer, Antonina A. Mikocka-Walus, Psychogastroenterology for Adults, 2019
A stool sample can be tested for infections, malabsorption, and inflammation. Faecal calprotectin is a useful test that can help to differentiate between inflammatory bowel disease (IBD) and IBS [5]. It is released when there is inflammation in the bowels. A normal faecal calprotectin level (<50ug/g) is highly suggestive of non-inflammatory bowel conditions such as IBS, in the right clinical context. It can also be helpful to assess disease activity, response to treatment, and prediction of disease relapse in IBD [6].
Abdominal pain in Finnish young adults with juvenile idiopathic arthritis
Published in Scandinavian Journal of Gastroenterology, 2022
Katariina Rebane, Anna-Kaisa Tuomi, Hannu Kautiainen, Suvi Peltoniemi, Mia Glerup, Kristiina Aalto
In this study, loose stools were the most common finding in the patients with frequent AP that can mimic the symptoms of IBD. Due to the small number of cases, we cannot make comprehensive causal interpretations. However, if a patient presents with these symptoms, it is advisable to test their calprotectin and if elevated a more detailed intestinal examination should be performed. In our cohort, all the patients with frequent AP had normal Hb and ESR values, had not been diagnosed with lactose intolerance and had not reported other GI – tract-related diseases, except the one patient with gastroesophageal reflux. Only one of the patients with frequent AP had a moderately increased value of FC, which normalized after discontinuing NSAIDs. It is also noteworthy that the patients with frequent AP were infrequently in remission off medication. This suggests that AP is a possible presentation of a medication induced gastrointestinal side effect. On the other hand, several congruences between the pathogenesis of the joint and gut inflammation have been identified, especially in spondylarthritis and psoriasis [41–44]. In addition, gut microbiota has been associated with the development of JIA and IBD [45,46].
Monitoring of intestinal inflammation and prediction of recurrence in ulcerative colitis
Published in Scandinavian Journal of Gastroenterology, 2022
Changchang Ge, Yi Lu, Hong Shen, Lei Zhu
Calprotectin is a calcium and zinc binding protein (S100A8/A9 heterodimer), mainly present in neutrophils, accounting for about 60% of the total cytoplasmic protein content of neutrophils [100]. Monocytes, macrophages and epithelial cells can also produce a small amount of calprotectin [101,102]. The destruction and death of related cells can trigger the release of calprotectin [103]. Thus, calprotectin can be detected in plasma, urine, stool, cerebrospinal fluid, saliva, synovial fluid, and colon biopsies and is positively associated with any existing inflammation. Stool is the most commonly used sample for detection of calprotectin. Because the stool is closer to the lesion, the concentration of the FC can reflect the degree of neutrophil migration to the gastrointestinal tract, and in healthy adults, the amount of calprotectin in faeces is about six times that in plasma [102,104]. Blood calprotectin level, especially plasma calprotectin (PC), has also been proved to be used to monitor the activity level of UC, distinguishing patients in remission from those in active phase. It is easier to obtain than FC and is less affected by the outside world. When measuring FC is hampered by patient compliance or other issues, a choice can be made. However, there are few studies on PC in UC patients and no comparative studies with FC. The assay of FC is still the sensitivity and specific marking of the most commonly used gastrointestinal inflammation [105,106].
Advances in tests for colorectal cancer screening and diagnosis
Published in Expert Review of Molecular Diagnostics, 2022
Sarah Cheuk Hei Chan, Jessie Qiaoyi Liang
Aside from hemoglobin, other fecal proteins can also be detected for CRC screening. However, the number of studies on this topic is limited. Transferrin is the main protein in the blood that binds to and transports iron throughout the body. Normally absent in the gastrointestinal tract, the presence of transferrin in feces indicates gastrointestinal bleeding [46]. Most studies indicate the detection of transferrin and hemoglobin improves the diagnostic accuracy for CRC [46–50]. Calprotectin is released by a type of white blood cell, neutrophil, and acts as a biomarker for gastrointestinal inflammation [51]. Although inflammation is involved in tumor progression [52], the effectiveness of calprotectin for CRC diagnosis is inconclusive, regardless of being measured alone or in combination with other markers [51,53–56]. The same situation applies to lactoferrin, another inflammatory marker. Lactoferrin is a non-heme iron-binding glycoprotein and is a prominent component of the first line of mammalian host defense. While some studies find fecal lactoferrin useful in detecting CRC [57–59], others have opposite findings [60].