Fecal markers in inflammatory bowel disease

Abstract

Numerous fecal biomarkers have been shown to correlate with disease activity in Crohn disease (CD) and ulcerative colitis (UC). Fecal calprotectin (FC) in particular has been extensively studied and shown to have sufficient sensitivity and specificity for detecting mucosal inflammation to aid in initial diagnosis prior to ileocolonoscopy. Furthermore, there are considerable data demonstrating excellent correlation of FC with endoscopic activity, prediction of inflammatory bowel disease (IBD) relapse, and therapy responsiveness. Emerging data in the use of FC for more continuous monitoring and tight control of IBD suggest improved outcome. Given its ease of collection and relatively inexpensive cost when compared to ileocolonoscopy, the current gold standard, the data suggest widespread use of fecal calprotectin in both screening and managing IBD. We suggest regular use of FC in symptomatic and asymptomatic patients.