scholarly journals The usefulness of fecal calprotectin testing in pediatric gastroenterology clinical practice

2020 ◽  
Author(s):  
Eliza Lężyk-Ciemniak ◽  
Magdalena Tworkiewicz ◽  
Dominika Wilczyńska ◽  
Anna Szaflarska-Popławska ◽  
Aneta Krogulska
Keyword(s):  
Gastrointestinal Tract ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Diagnostic Methods ◽  
Delay In Diagnosis ◽  
Number Of Children ◽  
Non Invasive ◽  
Course Of Action ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Abstract Gastrointestinal tract symptoms such as abdominal pain, constipation, diarrhea, and fever are frequent causes of visits to the pediatrician. The increasing prevalence of chronic gastrointestinal tract diseases, and the falling median age of their onset, indicate the need to identify new diagnostic methods that can differentiate inflammatory bowel diseases from other gastrointestinal tract conditions. A promising non-invasive and useful marker of intestinal inflammation is fecal calprotectin. The manuscript summarizes currently available information on the use of fecal calprotectin in the diagnosis and monitoring of inflammatory bowel disease in children. It also attempts to determine the effect of concentration on its course of action. Incorporating fecal calprotectin (FC) testing within the framework of primary medical care can decrease the number of children unnecessarily referred for endoscopic or radiologic examination. FC screening benefits patients by reducing any delay in diagnosis and avoiding unnecessary exposure to endoscopy, and benefits physicians by reducing pressure on endoscopy testing and assisting the decision. The present paper emphasizes the role of fecal calprotectin as a non-invasive marker for monitoring disease activity and efficacy of therapy, and predicting postoperative relapses, primarily in patients with IBD.

scholarly journals Effectiveness of Mediterranean Diet’s Adherence in Children with Inflammatory Bowel Diseases

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 3206 ◽  
Author(s):  
Caterina Strisciuglio ◽  
Sabrina Cenni ◽  
Maria Rosaria Serra ◽  
Pasquale Dolce ◽  
Massimo Martinelli ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Protein Intake ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Dietary Intakes ◽  
Food Diary ◽  
Significant Difference ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Mediterranean

Background: Nutritional support is very important in the treatment of Paediatric Inflammatory Bowel Disease (IBD). The role of the Mediterranean Diet (MD) has been understudied in children with IBD. The aims of this study were to assess the dietary intakes of IBD children in comparison with healthy controls (HCs), their adherence to MD; and the relationship between inflammation and dietary behaviors. Methods: Paediatric IBD patients in clinical remission and HCs were enrolled. The nutritional status and adherence to the Mediterranean Diet was evaluated through a 3-day food diary and the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED). Results: The analysis of food diaries showed a significantly higher kilocalorie intake in IBD patients compared to HCs (p = 0.012), an increase in carbohydrates (p = 0.015) and in protein intake (p = 0.024). Both IBD and HCs have an intermediate adherence to MD. The comparison between Crohn’s disease (CD) and Ulcerative colitis (UC) patients showed significant difference in protein intake in CD patients (p = 0.047), as well as for vitamin D (p = 0.044) and iron intake (p = 0.023). Interestingly; in IBD patients we found a significant association between adherence to MD and a low level of fecal calprotectin (p = 0.027). Conclusion: Children with IBD in remission have a sub-optimal food intake compared to HCs. MD seems to correlate to decreased intestinal inflammation.

scholarly journals P211 Pseudopolyps are associated with increased fecal calprotectin levels in patients with Inflammatory Bowel Disease in clinical and endoscopic remission

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S270-S271
Author(s):  
I Spigarelli De Rábago ◽  
C Suárez Ferrer ◽  
J Poza Cordón ◽  
E Martín Arranz ◽  
M Sánchez Azofra ◽  
...  
Keyword(s):  
Fecal Calprotectin ◽  
Clinical Settings ◽  
Optimal Cutoff ◽  
Non Invasive ◽  
Endoscopic Remission ◽  
Active Colitis ◽  
Bowel Diseases ◽  
Endoscopic Score ◽  
Inflammatory Bowel ◽  
Histological Activity

Abstract Background Fecal calprotectin (FC) has become a fundamental tool in the non-invasive monitorization of activity in patients with inflammatory bowel diseases (IBD). However, there is still debate over the choice of the optimal cut-off point for the different clinical settings. The aim of this study is to analyze whether the presence of pseudopolyps and their characteristics have an impact on the value of FC and should therefore be taken into account when deciding the optimal cutoff values. Methods A single-centered, retrospective analysis including data from patients with colonic Crohn′s disease or Ulcerative colitis who underwent colonoscopy for dysplasia screening at our center between 2018 and 2019. Patients that did not have a FC registered within 8 months from to the colonoscopy, or that did not maintain clinical remission between the colonoscopy and the measurement of the FC, were excluded. Patients that had activity in the colonoscopy (Mayo endoscopic score >0, SESCD >0) were also excluded. Results 73 patients were included. 26 (35.6%) of them had pseudopolyps in the colonoscopy. The median value of the FC was significantly different in patients with pseudopolyps (110.1 µg/g, CI 95% [48.6–171.5]) compared to those without them (52.5 µg/g, CI 95% [29.9–75.1]). In 11 (42.3%) of the patients with pseudopolyps, biopsies were taken, observing histological activity in 3 of them (27.3%) and no inflammatory activity in the other 8 (72.7%). We found that FC was higher in patients with inflammatory polyps (119.0 µg/g) in comparison to those without histological activity in their pseudopolyps (96.9 µg/g); however, these results were not statistically significant. The location of the pseudopolyps had no influence over the FC in our study. In addition, no correlation was found between the presence of polyps or diverticula and FC. Conclusion In our study, the presence of pseudopolyps is associated with significantly higher levels of FC. Moreover, our results suggest a tendency towards higher FC in patients who had active colitis in the histological samples of their pseudopolyps.

Fecal calprotectin in inflammatory bowel diseases: update and perspectives

2017 ◽  
Vol 55 (4) ◽  
Author(s):  
Hana Manceau ◽  
Valérie Chicha-Cattoir ◽  
Hervé Puy ◽  
Katell Peoc’h
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Therapeutic Response ◽  
Fecal Calprotectin ◽  
Intestinal Wall ◽  
Therapeutic Monitoring ◽  
Non Invasive ◽  
Bowel Diseases ◽  
Calprotectin Level ◽  
Inflammatory Bowel

AbstractInflammatory bowel diseases (IBDs) are chronic diseases that result from the inflammation of the intestinal wall, suspected in any patient presenting with intestinal symptoms. Until recently, the diagnosis was mainly based on both clinical and endoscopic arguments. The use of an easy, fast, reliable, non-invasive, and inexpensive biological assay is mandatory not only in diagnosis but also in evolutionary and therapeutic monitoring. To date, the fecal calprotectin is the most documented in this perspective. This marker allows the discrimination between functional and organic bowel processes with good performance. The determination of the fecal calprotectin level contributes to the evaluation of the degree of disease activity and to monitoring of therapeutic response.

scholarly journals The “Gum–Gut” Axis in Inflammatory Bowel Diseases: A Hypothesis-Driven Review of Associations and Advances

2021 ◽  
Vol 12 ◽  
Author(s):  
Kevin M. Byrd ◽  
Ajay S. Gulati
Keyword(s):  
Gastrointestinal Tract ◽  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Reciprocal Relationship ◽  
The Body ◽  
Current Understanding ◽  
Upper Airways ◽  
Periodontal Inflammation ◽  
Bowel Diseases ◽  
Inflammatory Bowel

In modern medicine, the oral cavity has often been viewed as a passive conduit to the upper airways and gastrointestinal tract; however, its connection to the rest of the body has been increasingly explored over the last 40 years. For several diseases, the periodontium and gingiva are at the center of this oral-systemic link. Over 50 systemic conditions have been specifically associated with gingival and periodontal inflammation, including inflammatory bowel diseases (IBD), which have recently been elevated from simple “associations” to elegant, mechanistic investigations. IBD and periodontitis have been reported to impact each other’s progression via a bidirectional relationship whereby chronic oral or intestinal inflammation can impact the other; however, the precise mechanisms for how this occurs remain unclear. Classically, the etiology of gingival inflammation (gingivitis) is oral microbial dysbiosis in the subgingival crevice that can lead to destructive periodontal disease (periodontitis); however, the current understanding of gingival involvement in IBD is that it may represent a separate disease entity from classical gingivitis, arising from mechanisms related to systemic inflammatory activation of niche-resident immune cells. Synthesizing available evidence, we hypothesize that once established, IBD can be driven by microbiomial and inflammatory changes originating specifically from the gingival niche through saliva, thereby worsening IBD outcomes and thus perpetuating a vicious cycle. In this review, we introduce the concept of the “gum–gut axis” as a framework for examining this reciprocal relationship between the periodontium and the gastrointestinal tract. To support and explore this gum–gut axis, we 1) provide a narrative review of historical studies reporting gingival and periodontal manifestations in IBD, 2) describe the current understanding and advances for the gum–gut axis, and 3) underscore the importance of collaborative treatment and research plans between oral and GI practitioners to benefit this patient population.

Role of serum calprotectin in diagnosis of inflammatory bowel diseases in patients with ankylosing spondylitis (preliminary results)

2021 ◽  
pp. 16-19
Author(s):  
G. V. Lukina ◽  
P. I. Kulakova ◽  
A. A. Novikov ◽  
E. N. Alexandrova ◽  
N. A. Savenkova ◽  
...  
Keyword(s):  
New York ◽  
Ankylosing Spondylitis ◽  
Inflammatory Bowel Diseases ◽  
Intestinal Inflammation ◽  
Fecal Calprotectin ◽  
Intestinal Pathology ◽  
Bowel Diseases ◽  
Seronegative Spondyloarthritis ◽  
Inflammatory Bowel

Background. Patients with inflammatory bowel diseases (IBD) often have lesions of the musculoskeletal system, which is an extra-intestinal manifestation and mainly belongs to the group of seronegative spondyloarthritis (SPA). Ankylosing spondylitis (AS) is one of the main forms of diseases from the group of spondyloarthritis, associated with IBD. The frequency of AS in patients with IBD is of interest for elucidating the general pathophysiology of diseases. Colonoscopy is required to diagnose intestinal pathology. Colonoscopy in patients with AS to detect IBD, especially in the absence of intestinal symptoms, is very diffcult. Mainly for the diagnosis of IBD, the defnition of fecal calprotectin is used. Recently, there has been an interest in serum calprotectin, an increase in which is associated with a higher activity of the disease and is a marker of the intensity of inflammation in the intestine. However, there is currently no consensus on the clinical signifcance for serum calprotectin.The aim. To evaluate the role of serum calprotectin in diagnosis of inflammatory bowel disease in patients with ankylosing spondylitis.Materials and methods. In the analysis were included 50 patients with AS, fulflling the modifed New York criteria, among them were 36 (72%) men and 14 (28%) women, the mean age of patients was 42.5 ± 9.9, mean disease duration was 13.4 ± 8.7 years. All patients were examined with ESR, CRP, FC (range: 100–1800 µg/g), esophagogastroduodenoscopy, colonoscopy and quantitative analysis of the SC level using ELISA (Buhlmann MRP8/14 ELISA, range: 0.4–3.9 µg/ml).Results. All patients had a high disease activity, mean BASDAI was 5.3 ± 1.8, mean ASDAS CRP was 3.7 ± 1.01, mean ASDAS ESR was 3.6 ± 1.01. 78% patients had high FC level (more than 100 µg/g), while only 18% patients had an increase of SC level. IBD were diagnosed in 11 cases: 6 (12%) patients with CD and 5 (10%) patients with UC, in the remaining cases (78%) was no intestinal pathology. Only two patients with IBD had a high SC level. SC level was more correlated with ESR (r = 0.5) and CRP (r = 0.5) (p < 0.05) levels, than with FC level (r = 0.4) (p < 0.05).Conclusion. The results have shown that there was currently insuffcient data to assess the possibility of using SC in the diagnosis of IBD in patients with AS. There was a signifcant association between the SC, CRP and ESR, but not fecal calprotectin. Potentially SC may be more representative for systemic inflammation than intestinal inflammation.

scholarly journals Landscapes and bacterial signatures of mucosa-associated intestinal microbiota in Chilean and Spanish patients with inflammatory bowel disease

2021 ◽  
Author(s):  
Nayareth Chamorro ◽  
David A. Montero ◽  
Pablo Gallardo ◽  
Mauricio Farfan ◽  
Mauricio Contreras ◽  
...  
Keyword(s):  
Intestinal Microbiota ◽  
Diagnostic Methods ◽  
Aerobic Bacteria ◽  
Healthy Individuals ◽  
Beneficial Bacteria ◽  
Facultative Anaerobe ◽  
Non Invasive ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Colonic Biopsies

Inflammatory bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), cause chronic inflammation of the gut, affecting millions of people worldwide. IBD have been frequently associated with an alteration of the gut microbiota, termed dysbiosis, which is generally characterized by an increase in abundance of Proteobacteria such as Escherichia coli, and a decrease in abundance of Firmicutes such as Faecalibacterium prausnitzii (an indicator of a healthy colonic microbiota). The mechanisms behind the development of the IBD and the dysbiosis are incompletely understood. Using samples from colonic biopsies, we studied the mucosa-associated intestinal microbiota in Chilean and Spanish patients with IBD. In agreement with previous studies, microbiome comparison between IBD patients and non-IBD controls indicated that dysbiosis in these patients is characterized by an increase of pro-inflammatory bacteria (mostly Proteobacteria) and a decrease of commensal beneficial bacteria (mostly Firmicutes). Notably, bacteria typically residing on the mucosa of healthy individuals were mostly obligate anaerobes, whereas in the inflamed mucosa an increase of facultative anaerobe and aerobic bacteria was observed. We also identify potential co-occurring and mutually exclusive interactions between bacteria associated with the healthy and inflamed mucosa, which appear to be determined by the oxygen availability and the type of respiration. Finally, we identify a panel of bacterial biomarkers that allow the discrimination between eubiosis from dysbiosis with a high diagnostic performance (96% accurately), which could be used for the development of non-invasive diagnostic methods. Thus, this study is a step forward toward understanding the landscapes and alterations of mucosa-associated intestinal microbiota in patients with IBD.

scholarly journals Landscapes and bacterial signatures of mucosa-associated intestinal microbiota in Chilean and Spanish patients with inflammatory bowel disease

2021 ◽  
Vol 8 (9) ◽  
pp. 223-238
Author(s):  
Nayaret Chamorro ◽  
David A. Montero ◽  
Pablo Gallardo ◽  
Mauricio Farfán ◽  
Mauricio Contreras ◽  
...  
Keyword(s):  
Intestinal Microbiota ◽  
Diagnostic Methods ◽  
Aerobic Bacteria ◽  
Healthy Individuals ◽  
Beneficial Bacteria ◽  
Facultative Anaerobe ◽  
Non Invasive ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Colonic Biopsies

Inflammatory bowel diseases (IBDs), which include ulcerative colitis (UC) and Crohn’s disease (CD), cause chronic inflammation of the gut, affecting millions of people worldwide. IBDs have been frequently associated with an alteration of the gut microbiota, termed dysbiosis, which is generally characterized by an increase in abundance of Proteobacteria such as Escherichia coli, and a decrease in abundance of Firmicutes such as Faecalibacterium prausnitzii (an indicator of a healthy colonic microbiota). The mechanisms behind the development of IBDs and dysbiosis are incompletely understood. Using samples from colonic biopsies, we studied the mucosa-associated intestinal microbiota in Chilean and Spanish patients with IBD. In agreement with previous studies, microbiome comparison between IBD patients and non-IBD controls indicated that dysbiosis in these patients is characterized by an increase of pro-inflammatory bacteria (mostly Proteobacteria) and a decrease of commensal beneficial bacteria (mostly Firmicutes). Notably, bacteria typically residing on the mucosa of healthy individuals were mostly obligate anaerobes, whereas in the inflamed mucosa an increase of facultative anaerobe and aerobic bacteria was observed. We also identify potential co-occurring and mutually exclusive interactions between bacteria associated with the healthy and inflamed mucosa, which appear to be determined by the oxygen availability and the type of respiration. Finally, we identified a panel of bacterial biomarkers that allow the discrimination between eubiosis from dysbiosis with a high diagnostic performance (96% accurately), which could be used for the development of non-invasive diagnostic methods. Thus, this study is a step forward towards understanding the landscapes and alterations of mucosa-associated intestinal microbiota in patients with IBDs.

scholarly journals Sarcopenia, severe anxiety and increased C-reactive protein are associated with severe fatigue in patients with inflammatory bowel diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Laura Tasson ◽  
Fabiana Zingone ◽  
Brigida Barberio ◽  
Romina Valentini ◽  
Pamela Ballotta ◽  
...  
Keyword(s):  
Fecal Calprotectin ◽  
Healthy Population ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Severe Fatigue ◽  
High Prevalence ◽  
Bowel Diseases ◽  
Moderate Fatigue ◽  
Inflammatory Bowel ◽  
Severe Anxiety

AbstractPatients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. A survey on fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua. Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.

Use of faecal immunochemical testing as an alternative to faecal calprotectin in children

2021 ◽  
pp. 000456322198935
Author(s):  
Kirn Sandhu ◽  
Sandhia Naik ◽  
Ruth M Ayling
Keyword(s):  
Bowel Disease ◽  
Intestinal Inflammation ◽  
Paediatric Population ◽  
Mucosal Healing ◽  
Faecal Calprotectin ◽  
Non Invasive ◽  
Three Samples ◽  
Immunochemical Test ◽  
Inflammatory Bowel ◽  
Rule Out

Background Faecal calprotectin has been widely used as a non-invasive marker of intestinal inflammation in children. Measurement of faecal haemoglobin using faecal immunochemical test is well established in adults for detection of colorectal cancer. In adults, faecal haemoglobin has been recommended as a reliable tool to aid identification of those at low risk of significant bowel disease and has also been used in inflammatory bowel disease to assess mucosal healing. Aims We aimed to evaluate the performance of faecal haemoglobin in the paediatric population and compare it with faecal calprotectin. Methods Children being assessed in the paediatric gastroenterology clinic for bowel symptoms had a sample sent for both faecal calprotectin and faecal haemoglobin. Samples were collected over a 10-month period from November 2018 to September 2019. Faecal haemoglobin was measured using an OC-Sensor. Faecal calprotectin was measured using Liason®Calprotectin. Results One hundred forty three samples were returned for faecal haemoglobin and in 107 a paired faecal calprotectin was also available. Faecal haemoglobin correlated with faecal calprotectin, Spearman’s rank coefficient 0.656 ( P < 0.0001). There were 35 patients with faecal haemoglobin >20 μg/g and in 32 of these patients faecal calprotectin was >200 μg/g; 74 patients with faecal haemoglobin and 38 patients with faecal calprotectin underwent colonoscopy. Patients with normal histology had faecal haemoglobin <4 μg/g; faecal haemoglobin >20 µg/g was associated with signification inflammation Conclusion Our study is the first to compare faecal haemoglobin and faecal calprotectin in a paediatric population. Results suggest that faecal haemoglobin correlates with faecal calprotectin and, as in adults, may be useful to rule out significant bowel disease. A faecal haemoglobin >20 μg/g was consistent with significant histological inflammation.

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