Faecal calprotectin in colonic diverticular disease: a case-control study

Int J Colorectal Dis. 2009 Jan;24(1):49-55. doi: 10.1007/s00384-008-0595-9. Epub 2008 Oct 22.

Abstract

Background and aims: Information about faecal calprotectin (FC) in colonic diverticular disease (DD) are lacking. We assessed FC in colonic DD, comparing it with irritable bowel syndrome (IBS) patients and healthy controls. Moreover, we compared FC levels in different degrees of DD and assessed FC in symptomatic DD before and after treatment.

Materials and methods: Forty-eight consecutive patients with a new endoscopic diagnosis of DD (16 with asymptomatic diverticulosis, 16 with symptomatic uncomplicated DD, 16 with acute uncomplicated diverticulitis), 16 healthy controls, and 16 IBS patients were studied. FC was assessed by semi-quantitative method and compared with histological inflammation. Moreover, FC was reassessed in symptomatic DD after 8 weeks of treatment.

Results/findings: FC was not increased in healthy controls and IBS patients. No difference was found between asymptomatic diverticulosis, healthy controls, and IBS patients (p = n.s.). We found higher FC values in acute uncomplicated diverticulitis (p < 0.0005) and in symptomatic uncomplicated DD (p < 0.005) than in healthy controls and in IBS patients. FC values correlated with inflammatory infiltrate (p < 0.0005). FC decreased after treatment to normal values both in acute uncomplicated diverticulitis (p < 0.0005) and in symptomatic uncomplicated DD (p < 0.005) after treatment. INTERPRETATIONS/CONCLUSIONS: FC may be useful to detect colonic inflammation in DD and in distinguishing symptomatic DD from IBS, as well as in assessing response to therapy in DD.

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Case-Control Studies
  • Colonoscopy
  • Diverticulosis, Colonic / drug therapy
  • Diverticulosis, Colonic / metabolism*
  • Feces / chemistry*
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Irritable Bowel Syndrome / metabolism
  • Leukocyte L1 Antigen Complex / metabolism*
  • Lymphocytes / metabolism
  • Male
  • Mesalamine / therapeutic use
  • Middle Aged
  • Neutrophils / metabolism
  • Rifamycins / therapeutic use
  • Rifaximin
  • Severity of Illness Index

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Gastrointestinal Agents
  • Leukocyte L1 Antigen Complex
  • Rifamycins
  • Mesalamine
  • Rifaximin