Predicting Active Disease in IBD

Most  patients with inflammatory bowel disease (IBD) are familiar with certain blood and stool tests that can assess how active their bowel disease is. One such test is the fecal calprotectin test ( Fcal for short). Calprotectin is a protein found in the stool in high amounts when there is inflammation.   The Fcal levels are helpful to determine if there is active disease in the bowel; if they are low it means no active disease or high, means active disease. There is a ‘grey zone” in the middle between 100 and 250 mcg/g which is difficult to interpret.

A recent study looked at the benefit doing of doing a blood test called C Reactive Protein (CRP), which is a common blood test assessing body wide inflammation, in addition to the Fcal stool sample test.  When the Fcal test was in the “grey area,” this study showed that the CRP blood level does help predict active disease if it is greater than 5 mg/l and Fcal is between 100 and 250mcg/gm.

These simpler tests can avoid invasive procedures such as Colonoscopy in some IBD patients. Now you know why the combination of both stool and blood samples can be very helpful.

Evelyn Gilkinson is the Nurse Lead for Charlton Health Inc. Before devoting herself solely to Infusing Biologics, Gilkinson worked at Toronto General Hospital, Flinders Medical Centre (Adelaide, Australia), and the London Health Science Centre in Thoracic Step Down, neonate, pediatric and adult Intensive Care, Recovery Room, and Emergency Medicine. Evelyn has done research for The Canadian Cervical Spine Study and with the AIM Health Group. She established the first out-of Hospital Infusion Centres in London and Waterloo. For the last twelve years, Evelyn was the Nurse Supervisor for South Western Ontario for many infusion sites until joining the Charlton team in the summer of 2016.

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