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Calprotectin normal

Hello,
Got a question. I have been semi diagnosed with mild Crohn colitis. I say semi because I hardly ever show anything wrong on colonoscopy. Have had ulcers show on capsule endoscopy in small bowel. I also have Rheumatoid arthritis. I went back to dr a week ago because I have been having watery, yellow diarrhea every day along with abdominal pain and urgency. I used to just get pain and diarrhea about 3 x a week but now it’s everyday. So I figured something got worse. I had a c-reactive test which was high but then I had a calprotectin test that just came back as normal. I know the arthritis can cause the c-reactive test to be high too. I’m set up for a colonoscopy in a week. I was just wondering if anyone knew if methotrexate could affect the calprotectin levels? I am just dreading them telling me everything looks good and nothings wrong when I know something is going on.

Thanks
Rae
 
Location
San Diego
I don't know that methotrexate directly suppresses calprotectin levels, but it certainly can lower the levels indirectly by lowering by lowering the inflammation - which is good. Lowering the inflammation is the main purpose of taking IBD medications in the first place.

So if your calprotectin is low that's one good sign that the medication is working. But since your are still having symptoms that's a sign that the problem has not been entirely cured. Make sure your doctor is aware of your pain and diarrhea problems and push him/her to keep adjusting your treatment to get you into full remission.
 

Maya142

Moderator
Staff member
I have been semi diagnosed with mild Crohn colitis. I say semi because I hardly ever show anything wrong on colonoscopy. Have had ulcers show on capsule endoscopy in small bowel. I also have Rheumatoid arthritis. I went back to dr a week ago because I have been having watery, yellow diarrhea every day along with abdominal pain and urgency. I used to just get pain and diarrhea about 3 x a week but now it’s everyday.
If you have ulcers in your small bowel, then you have more than colitis - you have small bowel disease too. So in addition to the colonoscopy, they should check your small bowel to see if there is active disease there - you'd need a capsule endoscopy or MRE to tell you that.

Patients with small bowel disease typically have with a lower Fecal Calprotectin than those with colitis.

And also remember the Fecal Calprotectin is only one test and no test is fail-proof!

However, if your scopes and small bowel is clean, then I'd definitely expect the high CRP to be from your RA.
 
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