What is the role of stool sample testing in the evaluation of Crohn disease?

Updated: Jul 26, 2019
  • Author: Leyla J Ghazi, MD; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Stool samples should be tested for the presence of white blood cells (WBCs), occult blood, routine pathogens, ova, parasites, and Clostridium difficile toxin. These studies should also be used to rule out infectious etiologies during relapses and before the initiation of immunosuppressive agents. [6]

Fecal calprotectin has been proposed as a noninvasive surrogate marker of intestinal inflammation in IBD. [66] The level of the inflammatory marker calprotectin in feces correlates significantly with endoscopic colonic inflammation in both ulcerative colitis and Crohn disease, and fecal lactoferrin is significantly correlated with histologic inflammation. [67] However, colorectal neoplasia and GI infection also increase fecal calprotectin; therefore, this study should be used with caution.

At present, fecal calprotectin is not in widespread use, except in research protocols. In the future, this marker may be made more available to clinicians for following patients’ disease activity.

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