Re-appraising the use of Faecal calprotectin sample (FC)

Faecal calprotectin (FC) serves as a calcium-binding cytosolic protein secreted by neutrophils, finding wide application as a screening tool for gastrointestinal inflammation. Numerous studies have highlighted elevated FC levels in patients with inflammatory bowel disease (IBD) compared to control groups like those with irritable bowel syndrome (IBS). Its utility extends to IBD management due to its correlation with disease activity markers. The cost-effectiveness of FC testing and its potential to reduce unnecessary referrals to secondary care have resulted in its widespread adoption in primary care settings. As a stable protein constituting a significant portion of neutrophil cytosolic content, calprotectin is released into feces during gastrointestinal inflammation, offering a non-invasive, cost-effective, and objective means of assessing patients before considering more invasive procedures such as colonoscopy or imaging studies. A prospective study will be conducted to assess the utility of faecal calprotectin (FC) testing in primary care settings, focusing on patients referred for this test. Baseline clinical information will be collected from recruited patients, and the Bristol Stool Scale score will be noted on the faecal samples sent for FC testing to gauge stool consistency. Participants will be followed up over a one-year period to track the outcomes of subsequent investigations, aiding in the determination of appropriate FC cut-off values and evaluating the impact of stool consistency on FC diagnostic efficacy. This research aims to address existing concerns regarding FC testing, particularly its application in primary care and the need for clearer cut-off values. By prospectively investigating FC utility and re-evaluating its cut-off value, this study seeks to enhance diagnostic accuracy in distinguishing between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) and streamline referral pathways for patients presenting with gastrointestinal symptoms.

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