Calprotectin Stool Test

People with digestive disorders know that they receive a series of blood and diagnostic tests on occasion. But it’s one thing to know that they happen, and quite another to interpret what the numbers say about your condition. 

One such test is the FCP, or the fecal calprotectin test. Also known as the calprotectin stool test, this test takes a sample of your stool and tests it for a chemical called calprotectin. Calprotectin is a biomarker of inflammation, and lets your GI know (in a minimally invasive manner) what is going on in your gut. 

If you’ve ever wondered why you had to bring a sample of stool to your local lab, this article was written just for you. 

What is Calprotectin? 

Calprotectin is a protein that is mainly found in white blood cells called neutrophils. Neutrophils are ‘first responders’ in your body against pathogens, and contain cytotoxic granules that, when released, eliminate threats in your body. 

When your body first identifies a threat, it sends signals, called chemokines, throughout the bloodstream, which alert your immune system to begin migrating to the site of attack and defense. Neutrophils contain signaling molecules that bind to blood vessels, enlarging them and making them more permeable so more immune defense actors can make it to the battlefield, while also sealing off the location in the body. We call this reaction inflammation, and it serves a valuable function in protecting the body from foreign invaders. 

The problem becomes when the immune system becomes dysregulated, and struggles to differentiate between self and foreign. This means that the body may alert the immune system to its own tissue, with immune actors such as neutrophils reacting and causing inflammation without a clear cause. Additionally, because there are bacteria in the gut, the increased sensitivity that a higher concentration of neutrophils in the area provides leads to increased inflammation and higher calprotectin release in the gut. Since calprotectin is resistant against breakdown by intestinal enzymes, fecal calprotectin is considered more stable and a better marker of gut inflammation than blood markers, leading to the decision to use it as a biomarker of inflammation in digestive disorders.

What is the Calprotectin Stool Test?

The test takes a sample of your stool (whether you are given a kit to take home and drop off at the lab at a later date or to perform in the lab itself) and measures the amount of calprotectin present. It is advised to take your medications exactly as you normally would before the test, unless otherwise directed by your doctor, and avoid NSAIDs and PPI medications, which both cause minor inflammation that could skew the results of your test. 

Results of Calprotectin Stool Test

The results should be interpreted relative to your BMI, age, and health status. For example, if you are in an active flare-up, it is probably that your FCP results will be elevated. Likewise, a taller person may have a higher numerical concentration of FCP than a short person, because they produce more cells that produce more calprotectin. Children typically have higher FCP values than adults. That said, always refer to your physician for a reliable interpretation of your FCP results. 

A normal or low range of FCP in adults is generally agreed on as below 50 micrograms/g, and indicates a low or normal amount of inflammation; nothing out of the ordinary. Therefore, if you have IBD and received this score it is likely that this would be considered your remission range, and on a biomarker level (regardless of symptoms), you are headed for treatment that maintains this remissive episode for as long as possible. 

A high range indicates an inflammatory state in your gut; this may indicate IBD or another condition, and you will likely be asked to do a CRP blood test, another inflammation marker, to confirm. However, a high range doesn’t always translate to IBD; it could indicate an issue with NSAID medication, celiac disease, or even a normal bacterial infection. 

What’s Next After A FCP Test?

If you received a high range of FCP values, it is likely that your doctor will order a colonoscopy. A colonoscopy is a small camera that is inserted into the body to view the colon, for purposes of visually observing the inflammation. 

If you have a history of gut health issues, your doctor may make a change in your medication to control the inflammation via a different or stronger means. Dietary or lifestyle changes may also be necessary to enhance clinical outcomes. 

Evinature Tips and Recommendations

It can be uncomfortable at first to discuss your stool and bowel movements with your doctor, and to present them with a sample, even more so. However, it is essential to keep the larger goal in mind, which is prioritizing your health and making sure you feel better. Be your own best advocate by talking to your doctor and becoming educated with resources like our blog to make sure you understand how to be present for yourself and gut condition. 

jonathan

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