Elevated Calprotectin level, need advice please!!

[Ihurt]

Hi everyone.

I don't want to rehash my whole story so I will try and narrow it down. I started having intestinal issues about 4 years ago or so( cannot remember exactly when). My symptoms were basically awful pain and cramping in my intestines. My stools however were completely normal. I had tests done ( MRE small bowel, blood work, CT scan, colonoscopy) all of which were normal. I had ups and downs where my intestines would feel ok some days and then not ok others. Well fast forward to this past July6th, I woke up and had a bout of watery diarrhea. Just once in the morning. I usually go once a day( sometimes feel like I have to go all the time though)but I feel crampy and icky all day and sit with heating pad. Well since July 6th, I have not had a normal bowel movement. I still go usually once a day, but now it is always soft and icky. It is usually either in pieces or like pudding consistency and always messy. I use literally half to whole role of TP to get clean. I then shower afterwards to prevent UTI's which I am very prone to.

Anyhow, my GI doctor keeps thinking IBS due to all my tests coming back normal before. I had my regular doctor just recently do a stool test for different things( parasites, bacteria, C-diff, calprotectin levels). All was normal except for the calprotectin level. I just asked the nurse today and she said my level was 348.5 where the normal reference range should have been anything less than 162. This obviously has me worried.

I see my GI doctor Wednesday and will bring a copy of this with me. I am not sure what he is going to say about it. I was taking a medication before I had that bout of diarrhea on July 6th called Uribel. It is for urinary pain( I have IC as well). This uirbel does contain a Saliscylate( NSAID). I was only taking a very small amount, but was on it since January( not every day, just on and off)
Like I would take one capsule a day for seven days and then lay off for a couple weeks etc. Well I had been on 1/2 capsule which is super low dose for over two weeks straight when I got the July6th diarrhea episode and have not felt good since. Could this have raised my calprotectin levels? I know that Calprotectin indicates inflammation in the intestines. I remember my GI testing for it a few years back and it was normal at that time. I remember him saying there are different things that can cause it to elevate. What are your thoughts on this? Does this indicate that I definitely have Crohns or UC of some sort, or can other things elevate this level?? Also, is mine considered really high at 348.5 when it says normal is anything under 162??? I am obviously worried and concerned and not sure what to think. I am certain my GI doc will not be overly concerned. Any suggestions or advice or thoughts are greatly appreciated.

 

[Clash]

There are definitely other things beyond IBD that can affect fecal calprotectin such has viral issues, NSAID use etc. But, I would think at least another fecal calprotectin in a few months would be warranted since your levels were above the norm.

When my son is on full flare his calprotectin levels are around 1700. Discuss the level with the doc and ask for further testing or at least investigating that result.

Hope you find some answers.

 

[Ihurt]

Clash: Thank you for the reply and advice. I definitely will be discussing it with my Gastro doc this Wednesday. I am guessing he may want to order the test over using his lab to see how it comes out, that is just my guess. Wow, your sons was really high. From what I have researched, it says normal would be under 50. The lab I had it done at ( Quest) says anything under 162 is normal. It is all so confusing. Is 348.5 considered very high? Sorry, I am just trying to learn as much as I can.

 

[Catherine]

Ihurt, my kid highest ever reading was 610.

Have they done any test of the small bowel? MRI?

 

[Ihurt]

Catherine: I had a small bowel MRE three years ago. I also had a colonoscopy about a year and half ago. They were both normal. At that time I had lots of intestinal crampiness and pain( though my stools were normal looking).
July 6th of this year, just over a month ago I woke up and had one bout of watery diarrhea. My poops have not the same since. Meaning they are always on the soft side. I was taking a medication for about 5 months prior (since about January) to all this( not every day though) called uribel. It is for my IC bladder pain. It contains a few different medications( methylene blue, Phenyl saliscylate which is an NSAID, hycosyamine, and one other med). I was only taking it like for a week or so at a time on and off and only 1/2 a capsule a day or one capsule a day which is a super low dose. I thought maybe something in this medication inflamed my bowels or digestive system, but I am not sure.

I stopped the medication well over a month ago, like July 7th. I had this Calprotectin test and other stool test around a week and half ago. Anyhow, so I am not sure what is going on. I see my GI doctor on Wednesday. Here is the thing, I was the one who asked my primary care to do this test. If I never asked her, I would never have known. My GI doc keeps saying I have IBS. I am not sure what he will think about this test being elevated. Everything I read says that people with IBD usually have very high numbers on their calprotectin test. What is considered very high though? It looks like every lab uses a different scale or reference range. I had mine at quest and they say their normal is anything under 162. I was at 348.5 . Would this be considered very high? I have been reading about people having as high as 1200 and above. Just very confused right now:ybatty:

 

[Mr chicken]

345 fc is high for a normal person
But not very high for anyone with Ibd
Fc indicates inflammation present but not necessarily Ibd
Full on Ibd flare is in the thousands
Ibd blip is in the 300 range .
A simple virus or infection can cause a slightly elevated number

 

[Ihurt]

Thanks for the info. I would not think it was a virus as I had this test done over three weeks after this first started( with the loose stool) which was July
6th. If it was viral, my guess is that it would have went away by now. Was tested for parasites and bacteria and that was negative. I however am getting my own stool pathogen test done from a better lab that checks for DNA stuff and they also check multiple inflammatory markers in the stool so I will be interested to see what it says. How accurate it the calprotectin test? My primary doctor did not even know what it was, I had to ask her to check for this. I know my GI doc knows about. I remember asking him about it a few years ago but kind of remember him saying it was not always very accurate( that may have been the lactoferrin test I was asking him about though, I forgot it has been awhile.

345 fc is high for a normal person
But not very high for anyone with Ibd
Fc indicates inflammation present but not necessarily Ibd
Full on Ibd flare is in the thousands
Ibd blip is in the 300 range .
A simple virus or infection can cause a slightly elevated number