Author/Authors :
Tavakkoli, Hamid Integrative Functional Gastroenterology Center and Department of Gastroenterology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan , Haghdani, Maryam Resident of Internal Medicine, Department of Gastroenterology, Alzahra University Hospital and Student Research Committee, Isfahan University of Medical Sciences, Isfahan , Haghdani, Saeid Department of Urology, Tehran University of Medical Sciences, Tehran, , Tavakkoli, Monireh Integrative Functional Gastroenterology Center, Isfahan University of Medical Sciences, Isfahan, , Daghaghzadeh, Hamed Integrative Functional Gastroenterology Center and Department of Gastroenterology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan , Gholamrezaei, Ali Poursina Hakim Research Institute, Isfahan, Iran, 7 Professor, Integrative Functional Gastroenterology Center and Department of Gastroenterology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan , Peyman Adibi Poursina Hakim Research Institute, Isfahan, Iran, 7 Professor, Integrative Functional Gastroenterology Center and Department of Gastroenterology, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan
Abstract :
Symptoms consistent with irritable bowel syndrome (IBS) are common among patients with inflammatory bowel
disease (IBD) in remission phase, and clinicians have difficulties in interpreting such symptoms as an ongoing disease activity or a
coexistent IBS. We investigated if the assessment of fecal calprotectin (FC) could be helpful in this regard. METHODS: The study
population consisted of 42 IBD patients in remission that fulfilled the IBS diagnostic criteria (Rome III), 24 IBS patients and 30
healthy controls. Clinical remission was determined based on physician’s assessments, not using corticosteroids or biological agents
within the preceding six months and activity indices. The FC and C-reactive protein (CRP) levels were investigated and compared
among the groups. RESULTS: FC levels were significantly higher in patients with IBD (142.9 ± 216.5 μg/g) than those with IBS
(24.9 ± 27.8 μg/g) and controls (17.9 ± 14.8 μg/g) (p < 0.001). CRP levels were also higher in IBD than IBS patients [3.9 (SE = 0.5)
vs. 2.1 (SE = 0.5), p = 0.030]. However, FC levels were not significantly correlated with CRP levels or with severity of symptoms in
IBD and IBS patients (p > 0.05). CONCLUSIONS: The presence of IBS-like symptoms in IBD patients in clinical remission may
reflect an ongoing activity of IBD, which is undetectable by current activity indices. Serum CRP levels are not specific enough in
such situation, and FC is a more accurate and specific test for investigating mucosal inflammation in this regard.
Keywords :
Inflammatory Bowel Disease , Crohn’s Disease , Ulcerative Colitis , Remission , Inflammation , Irritable Bowel Syndrome , Inflammatory Bowel Disease , Crohn’s Disease , Ulcerative Colitis , Remission , Inflammation , Irritable Bowel Syndrome
