Most Americans are familiar with gut inflammation and its symptoms of stomach cramping, diarrhea, excessive gas, and constipation. Such symptoms often accompany acute illness from viruses and bacteria such as those that cause food poisoning.
Inflammation is a sign that your body’s immune system has amped up to clear out an infection, and when it succeeds, symptoms often subside, and your body returns to homeostasis.
When bothersome gastrointestinal (GI) problems persist and normal activities are interrupted for many days or weeks—especially in the absence of an infection—it’s common to think a visit to a gastroenterologist may be helpful.
IBS, IBD, and Dementia
Calprotectin is a protein made by neutrophils, a type of white blood cell. It rushes to the gut when there is inflammation or infection. Higher amounts indicate inflammation, which can help doctors distinguish whether you may be dealing with inflammatory bowel disease (IBD) or irritable bowel syndrome (IBS), the latter of which isn’t inflammatory in nature. Emerging research also is connecting the test to dementia, which is also related to IBD.
“As a primary care doctor, I want to be assured I’m not delaying a diagnosis by labeling someone with IBS and treating them for that rather than missing a case of IBD,” he told The Epoch Times. “IBD has more potential harms of being missed because it is associated with colon cancer. They need to be watched very closely. Patients with IBS don’t have those same risks, even though they do have a number of distressing symptoms.”
IBD is an autoimmune condition in which the body attacks tissues in the intestinal tract and is considered chronic. There are two types of IBD, Crohn’s disease, which can affect any part of the GI tract from mouth to anus, and ulcerative colitis, which is isolated to the large intestine. Some patients may have both forms of IBD.
Managing IBD
First demonstrated to have clinical application in 1992, calprotectin is among the tools that help physicians diagnose IBD, although it doesn’t discriminate between ulcerative colitis and Crohn’s disease. The test may also register high numbers for other inflammatory conditions including infections, diverticulitis, cancer, and damage from nonsteroidal anti-inflammatory drugs.“A growing number of studies suggest an increasingly recognized role of the test in monitoring disease activity and response to therapy, as well as in predicting disease relapse and POR [post-operative recurrence], including pouchitis [inflammation of the pouch created during surgery for IBD],” the article states.
Higher levels of fecal calprotectin have been noted to correspond with IBD patients who are at risk of relapse, Dr. Bryce explained. This can raise the standard of care and potentially prevent frequent endoscopies, an invasive test that allows doctors to see inside the GI tract.
Ruling Out IBS
Because there is no definitive imaging, stool, or blood test to confirm IBS, a doctor may want to run other diagnostics to rule out different conditions such as small intestinal bacterial overgrowth, parasites, malabsorption, celiac disease, lactose intolerance, and other conditions.While the cause of IBS is unknown, it’s thought to have a component of nervous system dysfunction. It doesn’t cause cancer or change the tissues of the GI tract, but it may involve debilitating symptoms such as rectal bleeding, nighttime diarrhea, and persistent pain.
Talk to Your Doctor
Anyone who is experiencing GI symptoms such as diarrhea and abdominal pain can ask a doctor about a calprotectin test, especially prior to colonoscopy. Insurance typically covers it, Dr. Bryce said.“The more people are talking about it, the more useful it will be,” he said, noting his goal is to spread the word about calprotectin screening to doctors and patients alike.
“I think one of the misconceptions patients have is just how darn much we can take care of in the office. It’s very popular these days for a patient to want to see a specialist for every condition. But the truth is that most specialist offices are backlogged or inaccessible, and most common issues can be treated by a good primary care physician. Get in, have a conversation, and ask really good questions.”
Doctors, he said, can be most beneficial for patient care when they are willing to listen to patient experiences and acknowledge that patients are the best experts when it comes to their own bodies.
Calprotectin, Aging, and Dementia
Often, biomarker tests can be useful even when patients have no symptoms at all. Newer findings involving high calprotectin levels that correspond with Alzheimer’s symptoms illustrate the possibility that this biomarker could even be used to detect disease in the early stages.Even those without Alzheimer’s disease had higher levels of calprotectin corresponding with lower scores on the memory test. Calprotectin levels do naturally rise with age, possibly because of changes in the gut microbiome—the bacteria, viruses, and fungi living in the gut and facilitating our bodies’ physiology—that can lead to inflammation.
“This study, although not definitive, provides additional evidence that changes in gut health could be linked to Alzheimer’s pathology,” Tyler Ulland, assistant professor of pathology and laboratory medicine at the University of Wisconsin–Madison School of Medicine and Public Health, said in a statement.
The authors theorized that microbiome alterations may be driving systemic inflammation that could cause toxins and infections to cross into the brain.
“It is therefore very important to continue to study the link between changes in the gut, such as inflammation or increased gut permeability, and Alzheimer’s disease onset and progression,” Mr. Ulland said.
