# Fecal Calprotectin Test: Diagnostic and to Monitor Active Inflammation



## Guest (Jul 12, 2003)

Research has been ongoing since 1992, possibly earlier, on the value of monitoring calprotectin in the stool to verify inflammation in the intestines. Nycomed of Oslo, Norway has developed a simple stool exam that is providing good results in differentiating IBS from IBD from some forms of intestinal cancer. Its also proving to be a good method of monitoring active inflammation in the intestines so that medication regimes can be adjusted accordingly.Its been studied in double blind clinical studies against the "gold standards" of diagnostic tests: the colonoscopy and Indium lavage scans. Mayo Clinic has done comparison studies with their own Mayo Labs developed HemoQuant fecal occult blood test and found the fecal calprotectin test superior.This test is being utilized in clinical trials in the US by some of our leading teaching hospitals. It has only recently been introduced to the US and so is not available for clinical use except thru Great Smokies Diagnostic Laboratory and mostly holistic/alternative medicine practioners.Do a PubMed search on calprotectin or calprotectin and intestine to read the peer reviewed medical journal abstracts to decide for yourself whether to pursue having this test. It is as simple, non-invasive and risk-free as the fecal occult blood test but far superior in results. http://www.ncbi.nlm.nih.gov/PubMed/ The CPT Code # for the fecal calprotectin test is 83520. You can use this code # to see if your insurance will pay for this test. You will also need to know the IDC-9 diagnosis requiring this testing. For Crohn's disease the code # is 555.9 Crohn's disease or Regional Enteritis.Only healthcare providers registered with GSDL can script this test. GSDL has a toll free number you can call to request a list of healthcare providers in your particular area. They can send it to you via e-mail immediately.Just be advised that most of these registered healthcare providers are holistic/alternative "medicine" professionals and make sure you KNOW what the office call fees and all attendant fees are going to be. GSDL will not quote you the cost of the test, that is set by the provider. You also have every right to make it clear to that provider that you are interested ONLY in the fecal calprotectin test and results and will not seek care from them but will continue receiving your medical care from your current doctor(s). Many holistic/alternative "medicine" professionals charge office call and other fees considerably higher than conventional medical and osteopathic doctors so it pays to shop and discuss fees thoroughly upfront first.


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## Guest (Jul 12, 2003)

Fecal Calprotectin Published Research Bunn SK, Bisset WM, Main MJ, Golden BE. Fecal calprotectinas a measure of disease activity in childhood inflammatorybowel disease. J Pediatr Gastroenterol Nutr 2001; 32(2): 171-7Fagerhol MK. Calprotectin, a faecal marker of organicgastrointestinal abnormality. Lancet 2000; 356(9244):1783-4.Tibble JA. Sigthorsson G. Bridger S. Fagerhol MK. Bjarnason I.Surrogate markers of intestinal inflammation are predictive ofrelapse in patients with inflammatory bowel disease. [JournalArticle] Gastroenterology 2000; 119(1):15-22.Berstad A, Arsland G, Folvik G. Relationship betweenintestinal permeability and calprotectin in gut lavage fluid.Scand J Gastroenterol 2000; 35(1):64-9.Tibble JA. Sigthorsson G. Foster R. Scott D. Fagerhol MK.Roseth A. Bjarnason I. High prevalence of NSAID enteropathyas shown by a simple faecal test. Gut 1999; 45(3):362-6.Roseth AG. Schmidt PN. Fagerhol MK. Correlation betweenfaecal excretion of indium-111-labelled granulocytes andcalprotectin, a granulocyte marker protein, in patients withinflammatory bowel disease. Scandinavian Journal ofGastroenterology 1999; 34(1):50-4.Roseth AG. Fagerhol MK. Aadland E. Schjonsby H.Assessment of the neutrophil dominating protein calprotectin infeces. A methodologic study. Scandinavian Journal ofGastroenterology 1992; 27(9):793-8.Tibble J. Teahon K. Thjodleifsson B. Roseth A. Sigthorsson G.Bridger S. Foster R. Sherwood R. Fagerhol M. Bjarnason I. Asimple method for assessing intestinal inflammation in Crohnï¿½sdisease. Gut 2000; 47(4):506-13.Limburg PJ. Ahlquist DA. Sandborn WJ. Mahoney DW. DevensME. Harrington JJ. Zinsmeister AR. Fecal calprotectin levelspredict colorectal inflammation among patients with chronicdiarrhea referred for colonoscopy. American Journal ofGastroenterology 2000; 95(10):2831-7.Ton H. Brandsnes. Dale S. Holtlund J. Skuibina E. SchjonsbyH. Johne B. Improved assay for fecal calprotectin. ClinicaChimica Acta 2000; 292(1-2):41-54.Thomas P. Rihani H. Roseth A. Sigthorsson G. Price A.Nicholls RJ. Bjarnason I. Assessment of ileal pouchinflammation by single-stool calprotectin assay. Diseases ofthe Colon & Rectum 2000; 43(2):214-20.Tibble JA. Sigthorsson G. Bridger S. Fagerhol MK. Bjarnason I.Surrogate markers of intestinal inflammation are predictive ofrelapse in patients with inflammatory bowel disease.Gastroenterology 2000; 119(1):15-22.Tibble JA. Sigthorsson G. Foster R. Scott D. Fagerhol MK.Roseth A. Bjarnason I. High prevalence of NSAID enteropathyas shown by a simple faecal test. Gut1999; 45(3):362-6.Roseth AG. Schmidt PN. Fagerhol MK. Correlation betweenfaecal excretion of indium-111-labelled granulocytes andcalprotectin, a granulocyte marker protein, in patients withinflammatory bowel disease. Scandinavian Journal ofGastroenterology 1999; 34(1):50-4.Roseth AG. Aadland E. Jahnsen J. Raknerud N. Assessmentof disease activity in ulcerative colitis by faecal calprotectin, anovel granulocyte marker protein. Digestion 1997; 58(2):176-80.Meling TR. Aabakken L. Roseth A. Osnes M. Faecalcalprotectin shedding after short-term treatment withnon-steroidal anti-inflammatory drugs. Scandinavian Journal ofGastroenterology 1996; 31(4):339-44.Alic M. Is fecal calprotectin the next standard in inflammatorybowel disease activity tests?. [Letter] American Journal ofGastroenterology 1999; 94(11):3370-1.


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