Clin Chem Lab Med. 2008;46(9):1275-80.
Otten CM, Kok L, Witteman BJ, Baumgarten R, Kampman E, Moons KG, de Wit NJ.
Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
BACKGROUND: Ruling out somatic bowel disease, such as inflammatory bowel disease (IBD), is an important goal in the management of abdominal complaints. Endoscopy is commonly used but is invasive and expensive. Mucosal inflammation in IBD can be detected through fecal biomarkers, though the present enzyme-linked immunoabsorbent assay (ELISA) tests require laboratory facilities. We validated the diagnostic performance of two new fecal rapid tests (FRTs) for the detection of calprotectin and lactoferrin and assessed their potential to differentiate IBD from irritable bowel syndrome (IBS). METHODS: The calprotectin and lactoferrin FRTs and ELISA tests were performed on the fecal samples of 114 patients referred for endoscopy, 80% of whom had IBS and 20% IBD, and validated against the endoscopic diagnosis. RESULTS: The sensitivity and negative predictive value of the calprotectin FRT were both 100%, whereas they were 78% and 95%, respectively, for the lactoferrin FRT. The specificity and positive predictive value were slightly higher for the lactoferrin FRT. Both FRTs had similar diagnostic accuracy as the corresponding ELISA tests. CONCLUSIONS: The calprotectin and lactoferrin rapid tests are as good as the ELISA tests in detecting colonic inflammation. Given their simple use, FRTs can support the non-invasive exclusion of IBD, notably in primary care.
Silberer H, Küppers B, Mickisch O, Baniewicz W, Drescher M, Traber L, Kempf A, Schmidt-Gayk H.
University of Heidelberg, Germany.
The aim of this prospective study was to compare five different leukocyte proteins in feces of patients with chronic inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and healthy persons who underwent prophylactic colonoscopy. METHODS: The leukocyte proteins calprotectin, lactoferrin, lysozyme, myeloperoxidase, and PMN-elastase were determined with immunoassays in fecal samples of three consecutive feces (e.g. three days) in 40 healthy persons, 39 patients with chronic IBD (of these 21 with Crohn's disease and 18 with ulcerative colitis), and 40 patients with IBS. RESULTS: ROC curves calculated for healthy persons and patients with IBD yielded the following areas under the curves (AUCs): PMN-elastase 0.916, calprotectin 0.872, myeloperoxidase 0.750, lysozyme 0.726, and lactoferrin 0.693. The AUCs of PMN-elastase and calprotectin were not significantly different (p = 0.327), whereas PMN-elastase or calprotectin vs. the other proteins were significantly different (p < 0.001). PMN-elastase and calprotectin correlated with the endoscopically classified severity of inflammation. All fecal leukocyte markers in IBS were found in the range of the healthy persons. Data on storage stability of leukocyte proteins in fecal supernatants are given. CONCLUSION: Fecal PMN-elastase and calprotectin support the differentiation of chronic IBD from IBS and correlate with the severity of inflammation.
These are simple stool test that can help differentiate between IBS and IBD conditions.
a lot of people with IBS also have hemmies. With blood its in part the color. IF its dark red in the stools as oppose to bright red, but bleeding should also be checked out.
In IBD there is over inflammation that can be seen with the tests. There also can be malabsorbtion on nutrients, weight loss, bleeding and red flags for an IBS diagnoses.
Diagnostic Testing in Irritable Bowel Syndrome: Theory vs. Reality
Diagnosis of IBS
Warning signs and symptoms are not typical of IBS. The doctor may want to run extra tests if you have any of the following:
Hope some of this info helps.
You also might want to get a second opinion perhaps.