IBS versus IBD: The Role of Fecal Calprotectin testing

Dr. Juliet Ghodsian, ND

Irritable Bowel Syndrome (IBS) is a gastrointestinal disorder involving abnormal gut contractions and increased gut hypersensitivity. Symptoms of IBS include abdominal pain, gas, bloating, mucous in stools, and irregular bowel habits with constipation, and/or diarrhea. Digestive upset of some type is one of the most common complaints in a Naturopathic medical practice. For some patients, what appears to be simple IBS can actually be something much more complex. Inflammatory Bowel Disease (IBD) is a term that encompasses a variety of disorders that present with chronic inflammation of the intestinal tract. For patients with an underlying inflammatory bowel disease like Crohn’s or Colitis, initial onset or recurrence of disease can present just like IBS. Both IBS and IBD can present with a significant amount of abdominal or intestinal pain. In IBS this pain is often due to trapped gas or hard stool, while with IBD acute inflammation of the intestinal wall can create pain that is localized to the area or that will refer to other parts of the abdomen. With IBD pain can progress to more problematic concerns like bowel adhesions, fistulas or abscesses.

If you or your health care practitioner suspect an inflammatory component to your digestive concerns, it is very important for your long-term health to rule out IBD. Getting an accurate diagnosis will help preserve your health and get you on the right track for treatment as soon as possible.

There are several diagnostic testing options available to your doctor to help differentiate between IBS and IBD. One of the most useful in this circumstance is a stool assessment called Fecal Calprotectin. The level of Calprotectin found in a stool sample will give a direct assessment of inflammation in the intestinal tract. Nearly 99% of patients who have active IBD have elevated fecal calprotectin levels.  If you or your doctor suspect IBD or simply want to rule it out as a possible diagnosis, fecal calprotectin levels can help you do this. Similarly, if you have an active diagnosis of IBD, calprotectin levels can be used to screen for relapse or remission. A fecal calprotectin result does not replace a colonoscopy. The imaging results from a colonoscopy may still be required to determine which type of IBD a patient has, but as a quick, non-invasive screen for bowel inflammation the fecal calprotectin test is very useful.

If you are suffering from IBS type symptoms and have a family history of colitis, Crohn’s disease, or any other autoimmune disease, consider a fecal calprotectin assessment as part of your medical work-up.