Some bugs can stay in the gut for years.
Stool testing can tell the doctor a lot, including certain tests that look for inflamation.
Fecal calprotectin in differential diagnosis of irritable bowel syndrome.
Article in Chinese
Li XG, Lv YM, Gu F, Yang XL.
Department of Gastroenterology, Peking University Third Hospital, Beijing 100083, China.
OBJECTIVE: To assess the value of fecal calprotectin as a non-invasive screening biomarker in differential diagnosis of irritable bowel syndrome compared with fecal occult blood test (FOBT), erythrocyte sedimentation (ESR) or C reactive protein (CRP). METHODS: Subjects were a total of 240 persons, including 60 patients with irritable bowel syndrome, 60 patients with colorectal cancer, 60 patients with chronic inflammation, and 60 healthy controls. 5 g fecal samples were collected within one week of endoscopy or before surgical operation. Fecal calprotectin was measured by an enzyme-linked immunosorbent assay (ELISA) kit in spot stool samples. At the same time, FOBT was measured; the results of ESR and CRP in hospital lab were collected. RESULTS: The median of fecal calprotectin concentrations were 12.21 mg/kg and 15.36 mg/kg in IBS and healthy controls,respectively. There was no statistical significance of calprotectin concentration between patients with IBS and healthy controls (P>0.05). The median of fecal calprotectin concentrations were 159.00 mg/kg and 466.00 mg/kg in colorectal cancer and chronic inflammation respectively. There were statistical significance between patients with chronic inflammation, colorectal cancer, and others (P<0.01). The maximal calprotctin concentration was with chronic inflammation; the medium with colorectal cancer; the minimum with IBS and healthy controls. When the cut-off limit was set as 50 mg/kg of fecal calprotectin, the positive rates of colorectal cancer, chronic inflammation, IBS and healthy controls were 85.0%, 91.7%, 10%, and 5%,respectively. Fecal calprotectin was much superior to FOBT, ESR and CRP. CONCLUSION: Fecal calprotectin as a non-invasive screening biomarker in the differential diagnosis of IBS and symptomatic chronic large intestinal organic disease was better than FOBT, ESR and CRP. It was simple, inexpensive, repeatable and no-invasive. It can be used as a biomarker in exclusion from related organic diseases before the diagnosis of irritable bowel syndrome.
PMID: 16778979
Inflamm Bowel Dis. 2006 Jun;12(6):524-34. Related Articles, Links
Role of fecal calprotectin as a biomarker of intestinal inflammation in inflammatory bowel disease.
Konikoff MR, Denson LA.
From the Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
ABSTRACT:: Calprotectin is an abundant neutrophil protein found in both plasma and stool that is markedly elevated in infectious and inflammatory conditions, including inflammatory bowel disease (IBD). We conducted a systematic review of the published literature regarding fecal calprotectin to evaluate its potential as a noninvasive marker of neutrophilic intestinal inflammation. Reference ranges for fecal calprotectin have been established in healthy adults and children, and elevated concentrations of fecal calprotectin have been demonstrated in numerous studies of patients with IBD. Fecal calprotectin correlates well with histological inflammation as detected by colonoscopy with biopsies and has been shown successfully to predict relapses and detect pouchitis in patients with IBD. Fecal calprotectin has been shown to consistently differentiate IBD from irritable bowel syndrome because it has excellent negative predictive value in ruling out IBD in undiagnosed, symptomatic patients. Fecal calprotectin also may be useful in determining whether clinical symptoms in patients with known IBD are caused by disease flares or noninflammatory complications/underlying irritable bowel syndrome and in providing objective evidence of response to treatment. Although more studies are needed to define fully the role of fecal calprotectin, convincing studies and growing clinical experience point to an expanded role in the diagnosis and management of IBD.
PMID: 16775498
The sibo testing is harder.
Certain tests are more accurate then others, I believe it is the hydrogen breath test as the most accurate at the moment.
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My website on IBS is www.ibshealth.com
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