EFFECT OF TREATMENT ON FECAL CALPROTECTIN LEVELS IN INFLAMMATORY BOWEL DISEASE
The incidence of inflammatory bowel disease (IBD) has steadily increased over the last few years. This rise is reflected in both the adult and paediatric population alike. Colonoscopic evaluation with histopathological confirmation are currently the diagnostic investigations for individuals with suspected inflammatory bowel disease and the follow-up investigations for known cases. The process of bowel preparation and the colonoscopy procedure are considered to be markedly uncomfortable by patients. There is a dire need for a simple, non-invasive, and economic screening test to make a presumptive diagnosis of inflammatory bowel disease. Calprotectin is a major protein found in the cytosol of inflammatory cells. Previous studies have demonstrated faecalcalprotectin estimation to be a potentially useful screening method. Further, this test may also be used to evaluate the treatment response in IBD patients. Thepresent study included 20 patients who either presented with clinical signs of IBD or had already been diagnosed with IBD on the basis of colonoscopic findings and had been on treatment for at least a period of one month. Age, sex, clinical symptoms, colonoscopic findings, histopathological reports, and current medications were obtained from the patients’ medical charts and patients were asked to provide a fresh stool sample at the time of visit. 5g of stool was collected and duplicated, and used in the estimation of calprotectin levels with an ELISA-kit. Correlation of calprotectin levels and HPE findings was done using the chi square test. Comparison of the mean values of calprotectin levels with HPE and colonoscopic findings were done using an independent ‘t’ test. A p value of <0.05 was considered statistically significant. Diagnosis on the basis of colonoscopy findings was compared to HPE findings, and the difference between the two investigations was found to be statistically insignificant. Diagnosis on the basis of faecal calprotectin levels was compared to HPE findings and the difference between the two investigations was also found statistically insignificant. Mean faecal calprotectin levels were significantly different between HPE positive and negative patients. Mean of calprotectin level was not statistically higher with newly diagnosed IBD patients (1302.5 μg/g) compared to known, treated IBD patients (1045.9 μg/g). The faecal calprotectin test had a higher sensitivity, higher negative predictive value and lower negative likelihood ratio towards diagnosing IBD when compared to colonoscopy. Faecal calprotectin estimation is as effective as colonoscopy and HPE in the diagnosis of IBD. There is insufficient evidence in the present study to determine whether faecal calprotectin levels may be used as a prognostic tool/ indicator of treatment response in IBD patients. Further studies are needed to confirm these findings.
8 , 1 , 2018
18 - 23