Fecal biomarkers in inflammatory bowel disease: how, when and why?

ABSTRACT

Introduction: Over the last thirty years knowledge on fecal biomarkers (FM) has substantially increased. Nowadays these non-invasive inflammation markers are used in the daily management of inflammatory bowel disease (IBD). The interest in investigating FM was motivated by the need of a simple, quick, disposable and less invasive marker of disease activity, which might remove the need for endoscopy when following up with patients.

Areas covered: Current literature was reviewed for articles regarding the role of FM in IBD diagnosis, activity, flare prediction, medication and surgical treatment response as well as how FM may differ in adult and paediatric IBD patient populations.

Expert commentary: Although FM is relevant in IBD patient follow-up, there isn’t enough data regarding FM reference values for different ages, different disease subtypes, disease localization/extension or response to therapy. Serial measurements of FM for each patient may be useful in accessing relapse in most patients. FM presented more consistent results when used as a predictive tool of relapse after ileocecal surgery in Crohn’s disease. Ongoing research will clarify FM role in decision-making IBD daily practice.

KEYWORDS:

• Fecal biomarkers
• fecal calprotectin
• fecal lactoferrin
• inflammatory bowel disease
• Crohn’s disease
• ulcerative colitis

Declaration of interest

P. Ministro is a consultant for AbbVie, Biogen pharmaceuticals, Ferring, Hospira, Pfeizer and MSD. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.