Calprotectin is a protein occurring in large amounts in neutrophil granulocytes,

where it accounts for 5% of total proteins and 60% of cytoplasm proteins.

Bacteriostatic and mycostatic properties of calprotectin are comparable to those of

antibiotics. For this reason the abundance of calprotectin in neutrophil granulocytes
and its antimicrobial activity suggest a substantial role in the defence of the
organism

Calprotectin has been found in several human biological materials:

serum, saliva, cerebrospinal fluid and urine. However, the assessment of
faecal calprotectin is a widely used method for the detection of bowel
inflammation severity. Calprotectin is an extremely stable protein, and it
can be found unaltered in stool for longer than 7 days.

When inflammatory processes occur, calprotectin is released due to the

degranulation of neutrophil granulocytes. In bowel inflammation,
calprotectin may be detected in the stool. The faecal assay provides
direct information about the inflammation site, whereas with serum or
plasma, inflammation might be located anywhere.
Faecal Calprotectin assay offers a number of advantages in the detection of bowel
inflammation. In IBD patients, i.e. patients affected by ulcerative colitis, Crohn's
disease and in the so-called indeterminate colitis, the calprotectin level is generally
very high. In IBS subjects, the calprotectin level is lower if compared to patients with
the active IBD

Higher levels of faecal calprotectin are associated with active inflammatory bowel
disease (IBD) - such as Crohn's disease or ulcerative colitis. Faecal calprotectin
testing helps clinicians distinguish between inflammatory bowel diseases and non-
inflammatory bowel diseases of the lower gastrointestinal tract.

IBS patients generally do not have raised faecal calprotectin levels as it is not an
inflammatory condition.
Inflammatory Bowel Disease, internationally known as IBD, include
ulcerative colitis, Crohn's disease and the so-called "indeterminate colitis

The main feature of Inflammatory Bowel Disease is a chronic inflammation of the

intestinal mucosa

IBD patients show calprotectin values usually higher than patients affected by
Irritable Bowel Syndrome (IBS)
Ulcerative Colits
Ulcerative colitis is an inflammation of the bowel affecting the surface layers of the
intestinal mucosa. It always originates from the rectum and may subsequently
extend to the whole colon. This makes ulcerative colitis different from Crohn's
disease which may affect several areas of the intestine

Patients with ulcerative colitis often suffer from rectum bleeding and have a
frequent urge for defecation

Crohn's Disease.
Crohn's disease may affect any part of the digestive tract from the mouth to the
anus. More generally it affects the terminal part of the small bowel (terminal ileum),
or the colon

Today it is known that the onset of Crohn's disease may be associated to three
interacting factors - genetic predisposition; tissue deterioration caused by an
immune reaction triggered by gastrointestinal bacteria ; several environmental
factors, including smoking, that increases the risk of onset of this disease.

Crohn's diseaseis characterised by diarrhoea (3-4 bowel movements/day) with semi-

liquid or watery stool and no visible blood (although occult blood is frequent).

Irritable Bowel Syndrome

Irritable Bowel Syndrome intestinal muscle contractions are longer and stronger
than in normal subjects

IBS may be due to an altering of the nerves controlling muscle contraction or

sensitivity of the bowel, while others believe that the central nervous system may
affect both of them.

SYMPTOMS
Cramps, nausea, abdominal pain are the main symptoms of Irritable
Bowel Syndrome along with variation in the consistency of stools and
defecation patterns, bloating, constipation, mucus and abdominal
distension.

While Irritable Bowel Syndrome may cause discomfort and stress

1- INFLAMMATORY BOWEL DISEASE( IBD)

ULCERATIVE COLITS

CROHN'S DISEASE

2-IRRITABLE BOWEL SYNDROME ( IBS)