More information about text formats
Practical Guidance on the use of faecal calprotectin
Brookes MJ et al
Frontline Gastroenterology 2018; 9:87-91
I read this article with interest particularly as I work in a community gastroenterology unit.
Our unit performs straight to test colonoscopy. We are referred a significant number of
patients who present with loose motions but do not have alarm symptoms or worrying family
histories.. Many of them are found to have faecal calprotectin levels which are only slightly
elevated or in the intermediate range.
Many of these patients are also taking proton pump inhibitors on a regular basis. A
colonoscopy is performed and colonic biopsies are taken which are almost always
normal. A paper, albeit with small numbers of patients, showed that proton pump
inhibitors may cause a rise in faecal calprotectin levels in normal subjects.
I recommend that, when it is safe and appropriate to do so, the GP considers stopping
proton pump inhibitors in such patients and repeats the faecal calprotectin in four weeks.
The aim here is to avoid unnecessary colonoscopy in a low-risk young patients, most of
whom have functionally related symptoms. I recent...
whom have functionally related symptoms. I recently communicated this advice to my GP
As far as I know there has not been such a larger study looking at the effect of proton
pump inhibitors on faecal calprotectin levels. However I think such a study is urgently
needed as we are all struggling to cope with the increasing demand for
colonoscopy. and some younger patients may avoid unnecessary invasive investigations.
1. Proton pump inhibitors are associated with elevation of faecal calprotectin and may affect specificity
Poullis, Andrewa; Foster, R.a; Mendall, Michael A.b
European Journal of Gastroenterology & Hepatology: May 2003 - Volume 15 - Issue 5 - p 573-574
2.Proton pump inhibitors may cause elevation in faecal calprotectin levels
Br J Gen Pract 2016; 66 (648): 350. DOI: https://doi.org/10.3399/bjgp16X685813
Dr Mike Cohen
GP with special interest in Gastroenterology