Related Experiment Video

Updated: Aug 1, 2026

Investigating Intestinal Inflammation in DSS-induced Model of IBD

Investigating Intestinal Inflammation in DSS-induced Model of IBD

Published on: February 1, 2012

Fecal calprotectin correlates with active colonic inflammatory bowel disease but not with small intestinal Crohn's

Eran Zittan^1,2, Orlaith B Kelly², Ian M Gralnek¹

¹Ellen and Pinchas Mamber Institute of Gastroenterology and Liver Diseases Emek Medical Center Afula Israel.

JGH Open : an Open Access Journal of Gastroenterology and Hepatology

|November 29, 2018

Abstract

Background:

The utility of fecal calprotectin (FC) in small intestinal Crohn's disease (CD) is unclear. We examined how reliably FC reflects clinical and mucosal disease activity in small intestinal CD, colonic CD, and ulcerative colitis (UC).

Methods:

A total of 72 Inflammatory Bowel Disease (IBD) patients (23 colonic CD, 14 isolated small intestinal CD, and 35 UC) were included. Clinical activity was assessed using the Harvey-Bradshaw Index (HBI) (CD) and Mayo score (UC). Inflammatory activity was assessed through ileocolonoscopy, cross-sectional imaging, C-reactive protein (CRP), and FC. Clinical activity was defined as HBI > 4 or Mayo clinical score ≥ 3. Endoscopy activity was defined as Mayo endoscopic subscore ≥ 1, SES-CD score ≥ 3, and Rutgeerts > i1.

Results:

In UC, FC was correlated with the Mayo clinical score (P < 0.0001) and was highly correlated with the total Mayo score (P < 0.0001). A cut-off value of FC 100 μg/g provided sensitivity of 88% and specificity 100% for endoscopic activity. FC was lower for patients with endoscopic and clinical remission compared to active endoscopic disease (median 100 vs 1180 μg/g, P < 0.0001). In colonic CD, there was a significant correlation between FC and endoscopic activity (P < 0.001). For an FC cut-off value of 100 μg/g, sensitivity was 100%, and specificity was 67%. In contrast, for isolated small intestinal CD, there was no significant correlation between FC and objective disease activity measured by either endoscopy or imaging (AUC 0.52, P = 0.58).

Conclusion:

FC is reliable for the detection of colonic mucosal inflammation in both UC and CD but is less sensitive and reliable in the detection of small intestinal CD.

Keywords:

Crohn's colitis endoscopy remission fecal calprotectin isolated small intestinal Crohn's disease ulcerative colitis

More Related Videos

Visualization of Estrogen Receptors in Colons of Mice with TNBS-Induced Crohn's Disease using Immunofluorescence

Visualization of Estrogen Receptors in Colons of Mice with TNBS-Induced Crohn's Disease using Immunofluorescence

Published on: March 12, 2020

Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model

Systematic Scoring Analysis for Intestinal Inflammation in a Murine Dextran Sodium Sulfate-Induced Colitis Model

Published on: February 14, 2021

Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...

Inflammatory Bowel Disease II: Crohn's Disease

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...

Inflammatory Bowel Disease I: Introduction

Inflammatory Bowel Disease I: Introduction

Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...

Inflammatory Bowel Disease II: Ulcerative Colitis

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...

Inflammatory Bowel Disease III: Crohn's Disease

Inflammatory Bowel Disease III: Crohn's Disease

Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory Bowel Disease IV: Clinical Manifestations

Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...

Articles linked to this work by shared authors, journal, and citation graph.

Childhood exposure to a sibling with Crohn's disease alters gut microbiome and Crohn's disease susceptibility.

Gut·2026

Curriculum on management of acute upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

Endoscopy·2026

Real-World Outcomes of Upadacitinib vs Risankizumab Among Anti-Tumor Necrosis Factor-Exposed Patients With Crohn's Disease.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association·2026

Clinical practice patterns in the pre-endoscopic management of individuals presenting with acute upper gastrointestinal bleeding: results of an international survey.

Therapeutic advances in gastroenterology·2026

An observational cohort study evaluating adalimumab concentrations for predicting non-recapture of biochemical response after dose escalation in patients with Crohn's disease experiencing secondary loss of response.

Journal of the Canadian Association of Gastroenterology·2026

β-Glucan and Inulin Estimated Intake Are Associated With Reduced Risk of Crohn's Disease, Improved Gut Barrier and Systemic Inflammation Markers, and Multi-Omic Signatures in a High-Risk Cohort.

Gastroenterology·2026

See all related articles