Calprotectin is a zinc-binding protein with strong antibacterial and antifungal properties. It is found in a type of white blood cell called neutrophil. The key role of calprotectin is the defense against bacteria and viruses. Increased levels of calprotectin are directly connected with GI tract inflammatory processes.
If inflammation in the gastrointestinal tract occurs, neutrophils move to the inflamed area and release calprotectin. The concentration of calprotectin in the stool sample is a significant biomarker and diagnostic indicator.
A wide variety of conditions can be detected by advanced stool tests that assess calprotectin biomarker. These are the three main inflammatory digestive issues that fecal calprotectin quantification can help identify:
Crohn’s Disease is an inflammation of the small intestine, that can involve any part of the digestive tract.
Ulcerative Colitis is an inflammatory bowel disease which can cause ulcers of the colon and rectum.
Symptoms of IBD: severe diarrhea, fatigue, abdominal pain, weight loss, and malnutrition.
One of the cutting-edge tests available nowadays for assessing calprotectin and other intestinal health markers is GI Map Stool test. It is a great aid in diagnosis and a way to prevent unnecessary painful and uncomfortable endoscopies.
Measuring fecal calprotectin is more than a recommended step for diagnosing IBD, it is a standard procedure. Numerous clinical trials have proved the effectiveness and usefulness of measuring fecal calprotectin.
As a rule, there are two scenarios with the patient presenting with gastrointestinal symptoms. Symptoms can be a sign of IBS (irritable bowel syndrome) or IBD (Inflammatory bowel disease).
Accurate measuring of fecal calprotectin sheds a light on the health issue hidden by common symptoms of IBS and IBD. Your diagnosis and treatment plan directly depends on the levels of calprotectin and whether there are any other pathogens present.
A low calprotectin level is proof that you have IBS, which is not as severe health issue as IBD. The stool sample with low calprotectin indicates the absence of inflammation and no need to go through an endoscopy.
Moreover, if your calprotectin levels are below 100 µg/g, you are likely to experience remission and ongoing mucosal healing. In other words, if your stool test shows low calprotectin level, this is great news!
Elevated levels of calprotectin, around 250 to 300 µg/g or above, is a red flag and indicator of IBD.
Such results mean that you have ongoing inflammation in your GI tract and might experience a flare. Unlike IBS, IBD is an inflammatory process, and the endoscopy procedure is a must to confirm the diagnosis.
Note: There are no fixed rules for calprotectin testing. Judging the test results depends on the country, test kit and, of course, the symptoms of the patient. Most of the practitioners consider 10 - 60 μg/mg to be a normal range of calprotectin. If your calprotectin levels are elevated (above 250 µg/g), this is definitely abnormal.
Assessment of calprotectin combined with patient’s symptoms gives a full picture, which prevents mistakes and helps make the right diagnosis.
Calprotectin testing can also indicate other gastrointestinal conditions such as food allergies and intolerances.
For instance, the most common allergy in babies under the age of 1 year is cow's milk protein allergy (CMPA). It occurs when the body abnormally reacts to the protein in the milk of cows and other animals. This immune reaction can damage a baby’s stomach if not to alter the diet and prescribe treatment.
CMPA can be IgE-mediated (immediate reaction) and non-IgE mediated (delayed reaction). It is much harder to diagnose the second type. The symptoms of non-IgE mediated CMPA can occur in 2 days or even in one week after drinking milk.
Blood and skin allergy tests won’t help diagnose the delayed reaction CMPA. However, testing calprotectin can help to make the right diagnosis.
It has been proved by trials that elevated calprotectin concentrations are associated with cow’s milk allergy. No doubts, calprotectin levels is a useful biomarker for diagnosing CMPA and its treatment.
Millions of people, both children and adults suffer from gastrointestinal infections every day. Some GI infections rapidly and easily resolve in a few days, other infections are potentially serious and even dangerous.
In mild cases that resolve in a few days, it is not necessary to go through numerous advanced testing and procedures. You can just follow these tips to treat your illness:
Note: Self-medication has potential risks. Don't take any medications without consulting your doctor.
If you are vomiting for more than 48 hours, have severe abdominal pains, and fewer, it is time to see a doctor and do some testing, including assessment of your calprotectin levels.
If the acute symptoms subside but you still "don't feel right", and have ongoing digestive symptoms it would be the right time to do a more advanced stool test to measure calprotectin levels plus assess if there are any pathogens present.
I recommend the G.I Map stool test to assess gut health.
Many recent trials and investigation show that calprotectin levels get increased during various GI infections, just like in the situation with IBD. Therefore, calprotectin concentration can help evaluate gut infections and implement effective infection control measures.
Allergies, infections, parasites, and viruses are not the only causes of high calprotectin concentration. There is one more reason for borderline calprotectin levels - intake of non-steroidal anti-inflammatory drugs (NSAID).
Many drugs, if not all, have risks of possible side effects, NSAID is not an exception. Some of the most famous non-steroidal anti-inflammatory drugs are ibuprofen, diclofenac, aspirin, and proton-pump inhibitors.
These medicines can be absolutely harmless. However, long-term use of those drugs may cause inflammation of the small intestine, and logically - high calprotectin levels.
Inflammation caused by NSAIDs is associated with gastrointestinal bleeding and even hospitalization. For this reason, patients on NSAIDs should be monitored by the doctor to prevent any complications.
Also, it is recommended to asses calprotectin concentration again in 2-3 months after NSAID treatment and previous calprotectin testing. This will help to make sure that there is no other reason (infection, virus, etc.) for high calprotectin concentration.
If you are taking NSAID's long term it is also important to look out for gastric bleeding.
Start with the optimization of your nutrition. What you consume, directly influences your gut health and activity of intestinal inflammation. While some foods can help you prevent nutrition deficiency and reduce inflammation, other foods can just aggravate your symptoms.
Keep track of what you're consuming and how you feel after a meal. You can use a small notebook or mobile application for your food notes. It will help you detect foods that worsen your symptoms and try reduce or eliminate those foods.
Note: Common triggers for inflammation of your GI tract can be the following foods:
You can bring your notes to the dietitian to build your personalized diet. The nutritionist or naturopath can recommend you IBD-friendly foods to consume and foods to avoid. A well-balanced diet tailored to your organism’s needs will help prevent nutrient deficiency and reduce inflammation.
The biggest problem connected with intestinal inflammation and diarrhea is dehydration. That’s why it’s important to drink a lot of water, juices, clear broths.
However, you have to avoid coffee and caffeinated drinks, sugary drinks and sodas, and of course, alcohol. They may just worsen your diarrhea.
If you have severe flares, you can consider a liquid diet. It consist of liquid meal replacements like the Elemental Diet. Although it may be not very pleasant and absolutely not tasty, the results may surpass your expectations - and it is only for the short term.
Note: The liquid diet requires constant guidance and monitoring by physician and nutritionist.
Probiotics can help you restore your gut ecosystem and reduce inflammation, and calprotectin concentration. Your doctor might prescribe you the following probiotics:
Note: Do not buy and take probiotics without consultation with a nutritionist. Take only the recommended daily dosage to avoid prolonged microbiome disturbance.
Note: Take herbal remedies, strictly following the recommendations of your doctor. Otherwise, you may just aggravate your health conditions.
Stress also influences your calprotectin levels and degree of intestinal inflammation. Obviously, this is not the main trigger of your digestive problems. However, from my own experience, I have noticed that many people report flare-ups during high-stress periods.
There are several methods of how you can gain control over stress and relax:
Aerobic exercises and yoga are the best ways to relieve stress and fight depression, which positively influences your overall health, including digestive system.
In order to beat stress, let out your emotion in the face-to-face conversation with your best friend. Don’t hesitate to schedule an appointment with your psychologist if you’d like to talk to a specialist and get some advice.
Breathing strategies and meditation can help you manage your stress and relieve tension. You can also try biofeedback to improve your emotional and mental health.
Smoking has one ’benefit’, it may help prevent ulcerative colitis. On the other hand, it negatively impacts your heart, lungs, skin and every part of your body including GI tract.
Moreover, constant smoking can cause Crohn's disease or make it worse, increasing the risk of relapse. If you want to optimize your gut health and reduce inflammation, you should stop smoking. It is not a recommendation, it is a must. Take your health seriously.
Assessing calprotectin levels can help detect inflammation in the intestines caused by IBD, gut infection, allergy or NSAID medication. Also, testing calprotectin is useful for monitoring the activity of digestive disorder and measuring the degree of inflammation.
You can measure calprotectin concentration with the help of G. I Map test in the comfort of your home. On the basis of the accurate results, you can get an effective plan on how to deal with intestinal inflammation. Note, that changing your diet and lifestyle is vital for successful treatment of disease like IBD.
If you have any questions on calprotectin properties and its role in treating inflammation of the GI tract, you are welcome to schedule a consultation with me.
Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions. As Seen
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