Fecal Calprotectin Elevations Associated with Food Intolerance/Malabsorption Are Significantly Reduced with Targeted Diets

Abstract

Inflammatory bowel disease (IBD) involves two clinically defined entities, namely Crohn’s disease and ulcerative colitis. Fecal calprotectin (FCAL) is used as a marker to distinguish between organic IBD and functional bowel disease in disorders of the irritable bowel syndrome (IBS) spectrum. Food components may affect digestion and cause functional abdominal disorders of the IBS spectrum. In this retrospective study, we report on FCAL testing to search for IBD in 228 patients with disorders of the IBS spectrum caused by food intolerances/malabsorption. Included were patients with fructose malabsorption (FM), histamine intolerance (HIT), lactose intolerance (LIT), and H. pylori infection. We found elevated FCAL values in 39 (17.1%) of 228 IBS patients with food intolerance/malabsorption and H. pylori infection. Within these, fourteen patients were lactose intolerant, three showed fructose malabsorption, and six had histamine intolerance. The others had combinations of the above conditions: five patients had LIT and HIT, two patients had LIT and FM, and four had LIT and H. pylori. In addition, there were individual patients with other double or triple combinations. In addition to LIT, IBD was suspected in two patients due to continuously elevated FCAL, and then found via histologic evaluation of biopsies taken during colonoscopy. One patient with elevated FCAL had sprue-like enteropathy caused by the angiotensin receptor-1 antagonist candesartan. When screening for study subjects concluded, 16 (41%) of 39 patients with initially elevated FCAL agreed to voluntarily control FCAL measurements, although symptom-free and -reduced, following the diagnosis of intolerance/malabsorption and/or H. pylori infection. After the initiation of a diet individualized to the symptomatology and eradication therapy (when H. pylori was detected), FCAL values were significantly lowered or reduced to be within the normal range.

Assessment of Intestinal Permeability and Inflammation Bio-Markers in Patients with Rheumatoid Arthritis

“…It is common in inflammatory bowel disease (IBD) and in RA research to use commercially available kits to assess zonulin, a marker of intestinal permeability, or calprotectin, a marker of intestinal inflammation, in blood or stool [ 8 , 23 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. However, there are insufficient data regarding which (fecal or serum) may be the more valuable diagnostic and prognostic biomarker for RA.…”

An immunochromatographic strip sensor for rapid and sensitive detection of candesartan, olmesartan medoxomil, and irbesartan in herbal beverages

“…12 As antihypertensive drugs are used to treat high blood pressure, they inevitably have adverse effects, such as sprue-like enteropathy when taking IRB and OLM. [13][14][15] Moreover, consumers who are already taking antihypertensive medications can be accidently overdosed with drugs.…”

Adverse Food Reactions in Inflammatory Bowel Disease: State of the Art and Future Perspectives

“…Gaining a deeper understanding of the impact of food intolerances on patients with IBD is crucially important. Recent research has shown that levels of fecal calprotectin, a widely used marker for distinguishing between functional and organic bowel disorders, as well as assessing the severity of IBD, may be elevated in patients with lactose intolerance, fructose malabsorption, or histamine intolerance [5].…”