Supporting the diagnosis of infantile colic by a point of care measurement of fecal calprotectin

Abstract

BackgroundInfantile colic (IC) is a condition characterized by extensive crying which affects about 20% of all infants during their first months of life. Most pediatricians diagnose IC only based on their clinical experience.AimInvestigating if a measurement of fecal calprotectin can support the diagnosis of IC.MethodsThe crying behavior of newborns was assessed using the Wessel's criteria. Fecal calprotectin levels were measured in non-colicky and colicky babies using a standard test that can be used at the time and place of patient care (point of care (PoC) measurement).ResultsColicky babies were found to have significantly elevated fecal calprotectin levels. Calprotectin levels were not influenced by gender, type of feeding, gestation age or birth weight. However, significantly elevated fecal calprotectin levels were found in cesarean section born babies. Fecal calprotectin ≥100 μg/g correlated with a colicky status of an infant while those <100 μg/g indicated a non-colicky status the error margin was 11.2 and 13.2%, respectively. Combining data of fecal calprotectin with information about the type of delivery made it possible to determine the colicky status in vaginally-born infants with fecal calprotectin ≥100 μg/g with an accuracy of 97.8%. As elevated fecal calprotectin levels in cesarean-born infants can be caused by IC, but also by the disturbed gut microbiota commonly found in these babies, the accuracy of diagnosing the colicky status of a cesarean-born infant with calprotectin levels ≥100 μg/g was less accurate (accuracy rate of 76.5%).ConclusionData from the study suggest that measuring fecal calprotectin should be considered by pediatricians to support the diagnosis of IC.The study was registered at ClinicalTrials.gov under NCT04666324.

Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

“…Here, we summarize several studies investigating fecal calprotectin levels and gut microbiota in infants with colic, shedding light on potential associations with this enigmatic condition. Sommermeyer et al[ 60 ] observed significantly elevated fecal calprotectin levels equal to or greater than ‎‎100 μg/g in infants with colic. Interestingly, factors such as gender, type of feeding, gestational age, and birth weight did not appear to influence calprotectin levels.…”

Lactobacillus reuteri in digestive system diseases: focus on clinical trials and mechanisms

“…In the past decades, numerous studies illustrated that the GI microbial profiles of infants with colic differ from those without colic in microbial diversity, stability, and community composition (de Weerth et al, 2013;Savino et al, 2017). Moreover, the results showed colicky infants were less frequently colonized by Lactobacillus, Bifidobacterium and more frequently enriched with the gasforming Coliforms (mostly Escherichia, Klebsiella) or other species (Savino et al, 2009;de Weerth et al, 2013;Savino et al, 2017;Sommermeyer et al, 2022;Kozhakhmetov et al, 2023).…”