Faecal calprotectin rises with any intestinal inflammation, including infection, NSAID use and, to a lesser extent, proton pump inhibitors. A single raised value in someone without symptoms is common and often settles.
Repeat it after stopping NSAIDs where possible, look for alarm features, and refer for endoscopy when it is persistently raised with symptoms.
- Ask about NSAIDs, recent gastroenteritis and proton pump inhibitor use before acting on a raised calprotectin.
- Repeat a mildly raised calprotectin before referring an asymptomatic patient.
- Refer promptly when raised calprotectin accompanies alarm features such as bleeding or weight loss.
- Do not use calprotectin to screen asymptomatic people outside a research setting.
Why it matters
A test that rises for many reasons can trigger needless endoscopy if read in isolation.
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