BACKGROUND: Fecal calprotectin (FC) is considered the best noninvasive way to assess disease activity in ulcerative colitis (UC). However, it is not known which is the more suitable moment for stool sampling in patients with increased stool frequency. The aims of this study were to assess the intraindividual variation of FC within day and to evaluate if the first bowel movement in the morning is the more suitable sample for FC measurement in patients with acute flares of UC. PATIENTS AND METHODS: Patients admitted because of active UC were invited to collect samples from several bowel movements (including the first in the morning) during the same day providing their ordinal chronology. FC was measured by means of a quantitative rapid point-of-care test based on lateral flow assay immunochromatography. RESULTS: Eighteen patients were included for a total of 56 stool samples. Most patients had extensive UC and severe disease activity. Within-day FC values varied widely, and the median coefficient of variation was 40% (5%-114%) with a median range of variation of FC values of 3887 mg/kg (69-9946). The sample from the first stool in the morning obtained the highest individual FC within-day value in 33.3% of cases and the lowest in 38.9%. CONCLUSIONS: FC values widely vary between motions in patients with active UC. Stool sample collection from the first bowel movement in the morning does not ensure the highest or lowest within-day FC value. In patients with overt active UC, a single FC determination should not be used as the basis for therapeutic strategies.
BACKGROUND: Fecal calprotectin (FC) is considered the best noninvasive way to assess disease activity in ulcerative colitis (UC). However, it is not known which is the more suitable moment for stool sampling in patients with increased stool frequency. The aims of this study were to assess the intraindividual variation of FC within day and to evaluate if the first bowel movement in the morning is the more suitable sample for FC measurement in patients with acute flares of UC. PATIENTS AND METHODS: Patients admitted because of active UC were invited to collect samples from several bowel movements (including the first in the morning) during the same day providing their ordinal chronology. FC was measured by means of a quantitative rapid point-of-care test based on lateral flow assay immunochromatography. RESULTS: Eighteen patients were included for a total of 56 stool samples. Most patients had extensive UC and severe disease activity. Within-day FC values varied widely, and the median coefficient of variation was 40% (5%-114%) with a median range of variation of FC values of 3887 mg/kg (69-9946). The sample from the first stool in the morning obtained the highest individual FC within-day value in 33.3% of cases and the lowest in 38.9%. CONCLUSIONS:FC values widely vary between motions in patients with active UC. Stool sample collection from the first bowel movement in the morning does not ensure the highest or lowest within-day FC value. In patients with overt active UC, a single FC determination should not be used as the basis for therapeutic strategies.
Authors: Anastasios Koulaouzidis; Taina Sipponen; Artur Nemeth; Richard Makins; Uri Kopylov; Moshe Nadler; Andry Giannakou; Diana E Yung; Gabriele Wurm Johansson; Leonidas Bartzis; Henrik Thorlacius; Ernest G Seidman; Rami Eliakim; John N Plevris; Ervin Toth Journal: Dig Dis Sci Date: 2016-03-23 Impact factor: 3.199
Authors: Ferdinando D'Amico; David T Rubin; Paulo Gustavo Kotze; Fernando Magro; Britta Siegmund; Taku Kobayashi; Pablo A Olivera; Peter Bossuyt; Lieven Pouillon; Edouard Louis; Eugeni Domènech; Subrata Ghosh; Silvio Danese; Laurent Peyrin-Biroulet Journal: United European Gastroenterol J Date: 2021-05-07 Impact factor: 4.623
Authors: Rahul Kalla; Nicholas A Kennedy; Nicholas T Ventham; Ray K Boyapati; Alex T Adams; Elaine R Nimmo; Micaela R Visconti; Hazel Drummond; Gwo-Tzer Ho; Rebecca J Pattenden; David C Wilson; Jack Satsangi Journal: Am J Gastroenterol Date: 2016-09-06 Impact factor: 12.045