Faecal calprotectin in differentiating between functional and organic bowel diseases

Abstract

Background and study aims There is a frequent overlap between the clinical presentation of functional and organic bowel disorders. The aim of this study was to assess the role of faecal calprotectin in differentiating between both groups of patients in order avoid the use of invasive diagnostic procedures in patients with low probability of having functional disorders. Patients and methods We prospectively studied 39 patients presenting with lower gastrointestinal symptoms. On the basis of clinical and colonoscopic criteria 20 had functional and 19 had organic bowel disorder (10 had inflammatory bowel disease and 9 had organic non-inflammatory bowel diseases). Ten healthy subjects were included as controls. Faecal calprotectin was measured in patients and controls by enzyme linked immunosorbent assay. Results Patients with inflammatory bowel disease had faecal calprotectin levels of 379.2 ± 177.9 μg/g (mean ± SD); this was higher than in patients with functional bowel disease [(27.97 ± 15.2 μg/g); p: 0.004] and healthy controls [(21.64 ± 11.3 μg/g); p: 0.0002]. Patients with organic non-inflammatory bowel disease had faecal calprotectin levels of 273.4 ± 157.8 μg/g, which is higher than in patients with functional bowel disorders [(27.97 ± 15.2 μg/g); p: 0.002] and healthy controls [(21.64 ± 11.3 μg/g); p: 0.0001]. There was no statistically significant difference between faecal calprotectin in patients with functional bowel disease and healthy controls ( p: 0.264), and between both groups with organic bowel disease ( p: 0.312). Conclusion Faecal calprotectin is a sensitive non-invasive method which can be used to identify patients with organic bowel disorders. It is not, however, able to differentiate between different types of organic bowel diseases.