Is It Irrelevant To Get An Elevated Calpro Test For Irritable Bowl Syndrome ?

Posted on Fri, 4 May 2012

Question: Hi, since 2008 I've had been diagnosed with IBS. Gone through one colonoscopy, lot's of blood work, gluten test, CBC (FBC), CRP, SR and everything comes back normal. Even the biopsies during colonoscopy turned out ok. In 2006 I also underwent gastroscopy with biopsy that were OK. However, I've had elevated f-calprotectin levels during three different tests (only semi-quantative tests, CalDetect) but also had three NON-elevated tests (which of one was quantative ELISA). Now I do not use NSAID, non-alcohol drinker and was not having a phlegm producing cold. The only medication I regular take is Nexium. Now I would like to hear your opinion on wether this could be normal. All the docs I've met have disregarded the elevated calpro tests and said that they were not relevant. (Two GI-specialist and two primary physicians). My symptoms now are quite mild, I have normal stools 1-3 times a day, and sometimes, maybe once each 14-21 days I have one or two loose stools.
My questions is, can I trust that the elevated cal pro tests do not signal something more sinister? I had a anascopy two weeks ago, that was normal. The doc only found small piles and a fissure.

Answered by Dr. Poorna Chandra K.S (17 hours later)

Hi,
Thanks for the query.

Fecal calprotectin is a marker of inflammation and is elevated in inflammatory disorders.

Irritable Bowel Syndrome also has low grade inflammation in intestines.

If you are other wise fine with no abdominal pain, loss of apetite or weight you need not worry too much. Just follow a good lifestyle, high fibre diet ,Fresh fruits and vegetables.
Beans like kidney beans and lima beans,Whole-grain breads and cereals.

Avoid:
Drinks with caffeine, such as coffee, tea or soda
Milk products
Alcohol
Chocolate
Wheat, rye or barley.

Hope i have answered your query.I will be available for follow up.

Regards

Above answer was peer-reviewed by : Dr. Radhika

Follow up: Dr. Poorna Chandra K.S (7 hours later)

Hi and thank you for the answer. As it turns out my symptoms are quite mild, and aside for the elevated f-calprotectin I really dont have any alarm signals. I've had three normal f-calprotectin tests also during the same period (two different test results during two days, one pos. and one neg.)

As my colon is examined through colonscopy and biopsies, and all was good, I only worry about if there is something wrong in the small intestines. However, since my IBS-debut in 2008 I actually gained weight (+9 kg) due to a healthy apetit and any organic disease in the small intestines would certainly not contribute to gaining weight, right?

IBS seems to be a ever changing condition and each time it flares up I start worrying if there actually is something more sinister going on. Thanx once again for your time.

Answered by Dr. Poorna Chandra K.S (16 hours later)

Hi,

Thank you for the follow up.

It is nice to know your understanding of the disease. You are right that none of the small intestinal diseases cause an increase in weight. Hence you may not worry about it.

IBS (change dramatically. If it does then you should always rule out other diseases which are long list to discuss here. The colonoscopy and biopsy rules out those in large intestine.

Let me know if you have any specific questions.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar