Fecal Calprotectin Question

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AZMOM

AZMOM

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Alright question for those of you whose docs order the FC like mine does

When I asked Claire's doc if the numbers were indicative of severity of disease activity, he said "not really" that he just looks for "normal" or "abnormal" and explained that it just shows the presence of inflammatory cells. So if the stool picked up a glop (his words lol) of mucus or pulled cells from a particularly inflamed spot, it could be higher than if it missed that spot another time.

I'm asking because Claire's had 3 consecutive tests and we want to be under the upper limit so badly! I can't remember if that's 121 or 150. Nevertheless, the values were >2500 (that one gave me chest pain), 678, and 348. The 348 was from last weekend. I want to believe falling numbers are indicative of good things. :)

I'm rambling but just looking for how you all are looking at those numbers......

PS Dusty - sed rate and crp were within normal limits. H&H looked good Red cells a little low so he'll watch to be sure she doesn't decide to quit making them. Lol. Liver enzymes are fine. Folic acid level through the roof - lol - gotta back off the supplement.
 
I have seen several articles/studies and if I recall correctly most lean to faecal calprotectin as having a correlation to disease activity. Don't quote me on that though!

The reference range we have here is <50 being normal and >50 being abnormal with a testing range of 15 - 3000. I personally would look to the falling figures as being indicative of response to treatment (mucosal healing). I see what the doc is saying and of course I may well be wrong but it seems a tad coincidental to me that there is a steady downward trend.

Was CRP and ESR abnormal at the outset or have they always been normal?

Dusty. xxx
 
ESR was 12. I'm happier when it's single digits but as long as we stay below 20, I'm good.
 
Where is the fecal calprotectin queen, imaboveitall, when we need her??? :D I don't know the answer to your question although I would think if the numbers continue to trend downward it's a good sign! I'm curious, how long has Claire been on MTX?
 
AZMOM said:
CRP is always normal. ESR is her indicator.
Click to expand...

Of course! :facepalm:

@ThatsWhatSheSaid...ESR is Erythrocyte Sedimentation Rate. It is another type of inflammatory marker found in the blood. Sometimes it is referred to as Sed Rate.

Dusty. xxx
 
How often should the inflammatory markers be checked if the disease seems to be stable.

We have never had the fecal tests done and my son only had his crp and esr checked on 4/24 and 5/23. His last esr was 10 and crp was 0.7. His next appointment is not until 7/30. Is that too long to wait? And, should I request the fecal tests be done for a more conclusive result?

He hasn't had any visible problems since starting the Pentasa, no more vomiting and he has gained weight, but he did complain of brief stomach pain about three weeks ago on 3 different occasions only lasting a few minutes each time but no more since.
 
In my opinion, :wink:, the fact that his ESR and CRP are normal (I assume his markers reflected his disease?), they are by our reference ranges but I don't know what your labs are, he is only on Pentasa and he appears to be doing well I wouldn't put him through the trauma of having bloods done until his appointment next month. You could have faecal calprotectin done but I don't know that is necessary as a routine test if his bloods tend to show any issues and he is doing well. I certainly do think it is useful when flaring and/or if your child's bloods do not reflect what you see in front of you.

My two have bloods done every 2 months but that is only because of the medication they are taking. If they weren't on meds or were on a 5ASA like Pentasa and were for all intents and purposes responding to treatment I would be happy with 6 monthly bloods and then just as a way of tracking progress and keeping an eye on any deficiencies that may crop up. I dare say in this circumstance they would be happy with annual in line with their GI visits! :lol:

Dusty. xxx
 
dearie - the ESR and CRP are "systemic" markers for inflammation. The fecal calprotectin looks for inflammatory cells within the GI tract. Our current doc is the first one to watch these numbers but they are supposed to be good. Fortunately Claire hasn't been prone to infection because the ESR & CRP are not specific to IBD. For example, Claire had a high ESR during an arthritis flare when her gut was fine. A friend's child had sky high CRP during pneumonia. Make sense? Anyway, it's still a little new to us and we've never had normal but then again, he only checks it when she's symptomatic.

Mom2one - She was on methotrexate for a year at age 4 with the arthritis. Most recently since June 2011 so we are right at a year again. Funny, it failed miserably with the JRA but we're having some moderate success with controlling the Crohn's.

J.
 
And Claire's labs are every 6 weeks. But when she was in remission, we got to quarterly. :)

J.
 
yes, this makes lots of sense. This is all still very new to us too. Thanks both of you, Dusty and J. I was so concerned that I was waiting too long to have his labs rechecked because I didn't want to miss any silent symptoms but with the ESR decreasing from 12 to 10 and the CRP staying in the normal range and the fact that his initial presenting symptoms have all improved I guess there's no immediate need to recheck right now.

Having 6 monthly bloods done is a great idea though. I'm sure my son would love the idea of just annuals too, but I would be sick with worry if we were to wait that long to have him rechecked!! LOL
 
When the nurse called with lab results, she explained that fecal calprotectin above 150 was elevated and that to a certain degree it was indicative of level of inflammation. You can't compare two people, but you can compare a person's results. At the time, my son's was 1275, which is why the colonoscopy was ordered...
 
Do you guys need a special container for this test? I did it a month ago and they told me the container wasn't appropriate and hence my poop was poop so to speak. I went to the lab for a new container and they gave me the same one.
 
NOGUTS - They always give me a special container. But then again I work there..... ;-) Kidding - everyone should get a complimentary specimen container. :ytongue:
 
These are the stool specimen jars they give us...

20707_Sarstedt_Fecal_Container_70ml_809924027.jpg


...obviously colour coded! The urine jars have yellow lids! :lol:

Dusty. :)
 
Thanks. I'll be really angry if I went through the waiting process and "collection process" again only to find that they can't run this test.
 
Dusty (& the rest of the fecal calprotectin crew ;)) -

We're back to 636 :(. Better than the dreaded >2500 but not as cheery as 348

Doc wants to add Entocort to the mix.....repeat FC in 4 weeks.

J.
 
SO sorry it went up-
That reminds me I need to find out what his last was. I know it was low just not sure how low.
 
Ugh hell J. :(:(:( I am so sorry to hear this. :hug:

Is Claire having symptoms along with the higher result?

Thinking of you all and sending loads of love and healing thoughts your way...:wub:

Dusty. xxx
 
Fecal calprotectin results.

Our GI will re do fecel calprotection and colonscopy close together mid year with the aim to making sure they match for Sarah. She believes with the research going into recal calprotectin the understanding of the results will only get better, and hopefully led to few colonscopies being necessary to monitor patients.

We will have a fecel calprotection test done before Christmas.
 
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I'm so sorry Claire's numbers are up, J :( How *is* she feeling...splendid I hope? No matter, we parents are unable to relax when numberrs "flare" :(
 
Sorry to hear the figure has gone up. Hope the Entocort does the trick and brings it right down for her!!
 
She's feeling "ok". Those of you that don't know her - she HATES to complain so I have to watch her like a hawk. Our GI thinks this test is a good indicator of disease inflammation before it shows up in the ESR/CRP. So we get it whenever we have lab work. We were on the every two month cycle but thanks to the "spike", we'll repeat in 4 weeks just before the appt.

J.
 
Johnny's Fecal cal was 587. It was his first test so I have nothing to compare it to but his CRP and ESR have been low normal range since December. When I spoke to the nurse she made it sound like it wasn't an outrageous number. She said there are kids in the 2000 range and the long term trend is more helpful. We are repeating Fecal Cal later this month.

How long does Mucosal healing take? If CRP and ESR go normal any idea when Fecal Cal should follow?

AZ mom I am glad your G.I. is checking every 4 weeks. My son's wanted to wait 6 months. Hoping Claire's numbers get back to 348 soon!!
 
Johnny's mom - well her CRP is always normal. ESR has been normal for about a year. It was this spring we had a >2500 result (they wouldn't measure higher) and GI sprang to attention. She doing well overall but I feel like we're walking a tightrope. GI says we are :).

When you say every six months that's the FC only right? Not his normal labs?

J.
 
Fwiw we were told every six months minimum for FC.
DS always has normal blood.
When things were out of whack symptom wise we did them back to back 4 weeks apart
 
Have to take back my thoughts that Entocort's not worth a crap (pun intended). :rof: We added it 4 weeks ago and FC is down to 287.

The GI is happy and so am I.

Plan is to hold steady unless she becomes more symptomatic. And we are joining the MRE club in March.

And.....he has a new student that will be with him for 4 years. Claire was decidedly unfriendly. When we got in the van I asked her what she thought about him. She said "he has a bowtie, his pants are too short and he looks like a joke. But.........Im sure he's nice". OUCH! At least now I know why she was quiet!

J.
 
Have to take back my thoughts that Entocort's not worth a crap (pun intended). :rof: We added it 4 weeks ago and FC is down to 287.

The GI is happy and so am I.

Plan is to hold steady unless she becomes more symptomatic. And we are joining the MRE club in March.

And.....he has a new student that will be with him for 4 years. Claire was decidedly unfriendly. When we got in the van I asked her what she thought about him. She said "he has a bowtie, his pants are too short and he looks like a joke. But.........Im sure he's nice". OUCH! At least now I know why she was quiet!

J.
 
YEAH For 287!!!!!! My G.I. said the goal is under 400.

Johnny's went down to 430. Better than 587! What was weird was when I asked the G.I. if Johnny's disease was mild or moderate and he said "non existent". How can that be with a fecal cal of 430? They also don't do another scope until he is 20 years old if things stay the way they are currently. Which means he would be an adult and they would never have scoped him to really see if his disease was "non existent". Don't get me wrong I am the first one to want to stick my head in the sand but it just wasn't what I expected them to say. My old G.I. didn't use a fecal cal so they scoped every three years.

They also took him off the Allopurinol and increased his 6mp. Blood work in 3 weeks to see how things are going. We went this route before so I am hoping things continue to go well.

Tell Claire the pants too short thing is a pet peeve of mine too. I do like the bowtie look, but I am old.

Glad to hear the good news :)
 
Yeehaw J! :mademyday: Long live Pentasa!

And.....he has a new student that will be with him for 4 years. Claire was decidedly unfriendly. When we got in the van I asked her what she thought about him. She said "he has a bowtie, his pants are too short and he looks like a joke. But.........Im sure he's nice". OUCH! At least now I know why she was quiet!
Click to expand...

I think you are very lucky she was quiet...:rof:

Can someone please explain to me what compels a doctor to wear a bowtie and what makes them think it is a good look?!
I swear outside of a formal event I don't know anyone who wears a bowtie except for doctors! Hmmmmm on second thoughts...maybe it's because it doesn't dangle in 'things'. :ylol:

So happy for you J! :poop:
Dusty. xxx
 
Awwwww love you, T. She's doing pretty well. Some random joint complaints and one weird bout of vomiting that freaked me a little.... But really she seems to be good. Growing like a weed! :D

How's Gabs?

J.
 
Yeah for good, and yeah for growing ! :)

Gab's is doing "ok", she's so strong and such a trooper !

Bless their hearts :heart::heart:

luv you!
xoxoxox
 
Hello AZMOM. I don't really have anything to add to this discussion but I want to thank you for the thread, it's been informative. My daughter is also 9, and has her first gi app this Friday. I can only imagine what you've been through with your daughter being diagnosed at age 6 :((( best wishes xoxo
 
Is the fecal Cal Protectiin a take home, do it yourself test that we pick up at the lab? My daughter just took the CRP and Sed rate test but haven't gotten the results yet.
 
Yep :). It's a stool test so you bring a stool sample to the lab and they result it.

J.
 
From what I understand the FC test measures the protien that the white blood cells give off when they break down in the gut so it can only happen if you have imflamation going on. we have never had one lower the 600 sending another off tomorrow, esr down to normal never had raised crp but dr says looks like remission but can never be sure till FC back and low. hope that helps
Katie
 

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