Fecal calprotectin: A selection tool for small bowel capsule endoscopy in suspected IBD with prior negative bi-directional endoscopy

Abstract

Measurement of FC levels prior to referral for SBCE is a useful tool to select patients with possible small bowel CD. A FC >100 μg/g is good predictor of positive SBCE findings, while FC >200 μg/g was associated with higher SBCE yield (65%) and confirmed CD in 50% of cases. Patients with FC between 50 and 100 μg/g had normal SBCE, despite symptoms suggestive of IBD. In all patients with clinical suspicion of CD and negative bi-directional endoscopies, FC assessment should be carried out prior to their referral for SBCE. Where FC is <100 μg/g (NPV 1.0), SBCE is not indicated.