Faecal Calprotectin test on Small bowel after Colectomy?

[Caz2004]

In 2013 I had a colectomy after suffering with severe crohns colitis. I have recently been suffering with symptoms which I believe is a flare up so I went back to my Gastro consultant and had a calprotectin test from stool taken from my bag( I have no large bowel left so I have an ileostomy)
This test came back negative which really surprised me as I have been getting quite obvious symptoms.I have recently been investigating and a few resources have stated this test to be accurate only on colonic inflammation.

Has anyone else had any experience with this test on small bowel crohns?

 

[eleanor_rigby]

I may be wrong but I think the reason fecal calproctectin tests are less accurate for testing inflammation in the small bowel compared to the large bowel is because the stool has to travel further down the GI tract and therefore inflammatory cells may be lost by the time it has been expelled. I am guessing this will be less likely a problem for you if you have no large bowel. That said, the small bowel is several metres long. I would probably see about further testing, such as a pill cam.

 

[Guerrero]

I confirm what eleanor wrote. My doctor told me the same.

What are your symptoms Caz2004?

 

[Optimistic]

Hi. i know many GIs are confident in FCP test but my son is an outlier. His result is never higher than several hundred even with massive flare and hospitalization. He can be in low side of normal and still have inflammation in biopsies. His crohns is throughout the tract. Go figure. He still does a quarterly FCP and we rely on the patterns (in him any change is bad) but he is one who needs scopes, pill cam and MRE for monitoring.

 

[Caz2004]

I confirm what eleanor wrote. My doctor told me the same.

What are your symptoms Caz2004?

Hi,
I have lost about 8lb since June. Albeit I need to loose a couple of stone anyway so first I thought bonus! Then inflammatory response in my joints especially my knees. Decreased appetite, watery output )more so than normal, intense back pain and bloating. A couple of weeks ago I got really bad with nausea and dizziness too. Feel so exhausted with brain fog! Felt good for about a year after ileostomy but then perianal abscesses started which my surgeon said he doesn't think Crohn's caused it. I had op on barbie butt to repair tracks from abscess but I'm still not well.

 

[Caz2004]

Hi,
I have lost about 8lb since June. Albeit I need to loose a couple of stone anyway so first I thought bonus! Then inflammatory response in my joints especially my knees. Decreased appetite, watery output )more so than normal, intense back pain and bloating. A couple of weeks ago I got really bad with nausea and dizziness too. Feel so exhausted with brain fog! Felt good for about a year after ileostomy but then perianal abscesses started which my surgeon said he doesn't think Crohn's caused it. I had op on barbie butt to repair tracks from abscess but I'm still not well.

When I was admitted for emergency surgery in 2013 with flare causing sepsis my CRP was 14! My bloods are always normal! I was misdiagnosed before. It took 10 years before they confirmed severe Crohn's affecting the whole colon.
I do feel they should do pill cam but I've had a CT scan too which didn't pick up anything either! Feel like this is dejavous!

 

[hcrum87hc]

My doctor usually orders several different labs to check if I'm flaring. These include CRP, sed rate, and fecal calprotectin. My CRP is usually only slightly elevated, but my calprotectin level is usually very elevated and more indicative of what's really going on. At my worst, my level came back at over 1400. After my surgery, it on the low end of normal.