PTU-061 Determining a value of faecal calprotectin above which colonoscopy is indicated in the county durham and darlington population

    loading  Checking for direct PDF access through Ovid



NICE guidelines1 have suggested the introduction of an ‘indeterminate’ range in faecal calprotectin that would include values that are above the reference range but not clinically significant in assessing for inflammatory bowel disease (IBD).2 BSG guidance has suggested that the value of faecal calprotectin above which colonoscopy is required should be determined by local audit. This audit is designed to determine that value for the County Durham and Darlington population.


A total of two-hundred colonoscopies requested at County Durham and Darlington Foundation Trust (CDDFT) between 1stDecember 2014 and 21st September 2015 with an indication of ‘raised faecal calprotectin’ were analysed. We looked at: the value of faecal calprotectin; findings at colonscopy; histological findings; and findings of small bowel imaging. CCDFT uses the EliA Calprotectin test and a raised value is defined as >50 mg/kg.


Fifty-five out of 200 (27.5%) of patients had an endoscopic, histological or radiological abnormality. 25 of the 47 patients with endoscopic inflammation did not have significant histological findings. All patients with abnormal histological or radiological findings had a faecal calprotectin >69 mg/kg.


Patients with a faecal calprotectin <200 mg/kg were more likely to have comparatively mild diagnoses. The greatest proprotion of patients with abnormal findings had a faecal calprotectin >200 mg/kg (30/38=78.9%). All patients with a definite diagnosis of IBD had a faecal calprotectin >147 mg/kg and the majority of these patients (18/22) had a faecal calprotectin >300 mg/kg.


Fifty-seven patients had a faecal calprotectin >300 mg/kg but normal histology following colonoscopy. Of these 57 patients, 19 had subsequent small bowel imaging of which 4 patients had abnormal findings.


Based on these findings, we would suggest that the indeterminate value of faecal calprotectin for CDDFT patients is between 50 mg/kg and 200 mg/kg. Colonoscopy should be considered in these patients depending on clinical history. Colonoscopy should be offered to those with a faecal calprotectin >200 mg/kg. In addition to this, small bowel imaging should be considered in those with a faecal calprotectin >300 mg/kg who have normal findings at colonoscopy.

Disclosure of Interest

None Declared

Related Topics

    loading  Loading Related Articles