Background and aims:The clinical course of inflammatory bowel disease is characterised by a succession of relapses and remissions. The aim of our study was to assess whether the predictive value of faecal calprotectin-a non-invasive marker of intestinal inflammation-for clinical relapse is different in ulcerative colitis (UC) and Crohn's disease (CD). Methods: Seventy nine consecutive patients with a diagnosis of clinically quiescent inflammatory bowel disease (38 CD and 41 UC) were followed for 12 months, undergoing regular clinical evaluations and blood tests. A single stool sample was collected at the beginning of the study from each patient and the calprotectin concentration was assessed by a commercially available enzyme linked immunoassay. Results: In CD, median calprotectin values were 220.1 mg/g (95% confidence interval (CI) 21.7-418.5) in those patients who relapsed during follow up, and 220.5 mg/g (95% CI 53-388) in non-relapsing patients (p = 0.395). In UC, median calprotectin values were 220.6 mg/g (95% CI 86-355.2) and 67 mg/g (95% CI 15-119) in relapsing and non-relapsing patients, respectively (p,0.0001). The multivariate Cox (proportional hazard) regression model, after adjustment for possible confounding variables, showed a twofold and 14-fold increase in the relapse risk, respectively, in those patients with CD and UC in clinical remission who had a faecal calprotectin concentration higher than 150 mg/g. Conclusions: Faecal calprotectin proved to be an even stronger predictor of clinical relapse in UC than in CD, which makes the test a promising non-invasive tool for monitoring and optimising therapy.

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Background: Helicobacter pylori has attracted increasing attention among gastroenterologists because of its pathogenic potential, stimulating the search for non‐invasive diagnostic tests. Aims: In this study the efficacy of a new enzyme immunoassay designed to detect H. pylori antigens in stools (HpSA) was evaluated before and after eradication therapy. Methods: HpSA was performed on stool samples collected from 268 patients whose H. pylori status was defined on the basis of concordant results for the 13C‐urea breath test, rapid urease test and histology. The H. pylori‐positive patients were treated with a 1‐week triple therapy to eradicate the infection. One (T30) and 3 months (T90) after the end of therapy, 13C‐urea breath test and HpSA were repeated in the treated patients. Results: The overall diagnostic accuracy of HpSA at T30 (83%, 95% confidence interval (CI) 77–89%) was significantly lower in comparison to the values obtained at baseline (94%, 95% CI: 91–97%) and at T90 (97%, 95% CI: 94–99%). No significant difference was found between the diagnostic accuracy of HpSA at baseline and at T90 (P=0.253). Conclusions: The present data suggest that HpSA provides a low diagnostic accuracy when used shortly after treatment. It needs a longer period of follow‐up (8–12 weeks) to reach a reliability comparable to the 13C‐urea breath test.