Inflammatory bowel diseases (IBDs) - Crohn's disease, ulcerative colitis, and IBD unclassified - are chronic diseases affecting the gastrointestinal tract. Their incidence, especially in the pediatric population, is growing at an alarming rate.
Patients with IBD have nonspecific symptoms such as abdominal pain and chronic diarrhea. Endoscopy with sampling for histological processing is needed for diagnosis.
However, this approach is invasive and requires general anesthesia in children. Additionally, endoscopy is also required during monitoring of patients with IBD to elucidate the intestinal inflammatory activity.
Consequently, there is a great need for a non-invasive and sensitive marker. Fecal calprotectin is a protein that is released from the cytoplasm of activated neutrophils, and its fecal level increases during bowel inflammation.
It is an ideal non-invasive biomarker with high sensitivity and specificity that enables differentiation of IBD from functional conditions such as irritable bowel syndrome, monitoring of inflammatory activity, and prediction of clinical relapse of IBD. Especially in non-symptomatic IBD, a low concentration of calprotectin in stools predicts the persistence of clinical remission.
This article provides an overview of the important role of fecal calprotectin in screening and monitoring of IBD, in addition to its limitations.