Fecal calprotectin concentration in adults with and without Helicobacter pylori infection

Helicobacter pylori (H.p.) is a very common cause of chronic gastritis. As an acute phase protein, calprotectin (CP) has a significant function during inflammation. The aims were to investigate the difference of fecal CP concentration in adults with and without H.p. infection, the effect of eradication therapy on fecal CP concentration, and to correlate between fecal CP concentration and the grade of activity of chronic gastritis in both groups.

Patients complaining of abdominal pain, referred to the gastroenterology outpatient clinic, were recruited in this prospective study. They provided stool samples to be tested for fecal CP, H.p. antigen and stool analysis with culture. Upper and lower endoscopies were offered, within 48 h, to all eligible patients with elevated fecal CP concentration irrespective of H.p. infectivity. Patients with H.p. infection received eradication treatment and were asked to provide a new stool sample to test fecal CP and H. pylori antigen.

A total of 186 patients (93 males and 93 females) were enrolled and divided into two groups according to their H.p. infectivity: 105 negative- and 81 positive-H.p. infection. Fecal CP concentration was significantly higher in the H.p. positive than negative group (p = 0·004) and significantly decreased (p < 0·0001) after receiving eradication therapy. Fecal CP concentration correlated significantly (r 0·60, p < 0·0001) with the grade of activity of H.p. induced gastritis.

Fecal CP concentration can be affected by H.p. infection. Helicobacter pylori eradication may improve fecal CP concentration.