Hi all, I was wondering if anyone has any experience with calprotectin levels post-surgery. I know this test isn't used super frequently but my GI likes it as a non-invasive way of keeping tabs on inflammation. During my worst flare in the hospital my calprotectin went up to 990, on high dose prednisone/Remicade/mtx it went down to about 350, which was my last measurement pre-surgery.

I've been doing GREAT since takedown, stable at 5-6 BMs per day now, so I was expecting my measurement to be pretty low, it came out to be 216. Although this is an "all time low" for me (since it was never tested before I was in a flare) it still seems pretty high. I've seen a few studies that looked at calprotectin in j-pouchers and they suggested using 92.5 or 182 as predictive cut-offs for pouchitis.

Has anyone else kept track of their calprotectin post-op? I'm wondering if perhaps it is just going to come down over time post-surgery? On the other hand, it doesn't make sense to me because I don't have small bowel involvement (to my knowledge...) and I can't imagine I have pouchitis with absolutely no symptoms.

Obviously I will talk to my GI about this but I'm curious to hear if others have input.
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It's a stool test actually - fecal calprotectin. It's a measure of intestinal inflammation. Interestingly it is consistently elevated in IBD patients but not IBS, and it has been shown to be correlated with endoscopic, histologic, and symptomatic severity of inflammation. All of this I learned today while trying to read about why mine would be so high Smiler
Within 2 weeks my son's cal protectin jumped from below 20 to over 190. Once he got new antibiotics and he to feel better. We have not yet re-tested his cal protectin -- but I would guess it has gone back down. I am wondering what is making his inflammation rise --( he is already treated for crohns with humira and methotextrate) -- it is when his antibiotics, which I presume are addressing SIBO were not working, that his inflammation increased. Why would sibo make his inflammation rise ? Infection, I guess? Thanks.
Liz, I had never heard of calprotectin before this summer when I had a calprotectin stool test to check for candida overgrowth in the gut. Through 3 years of UC and a J-pouch in 1994, I don't recall stool tests or mention of calprotectin...but, that was in the Old Days! I don't know if I can answer your questions but you provided some helpful information about the levels for J-pouchers. I would love to know where you came across those numbers. I was told that 51 was high and that 95% of population are around 15. It could be they didn't account for people with J-pouches. I did do another sample for a lab called Genova that provided more detailed results about good and bad flora levels. I just did another simple calprotectin sample a week ago and am waiting for the resulting number. I agree with you that it's hard to think that you have pouchitis without having noticeable symptoms. I had my surgery in 1994, and have only been treated once for pouchitis (with antibiotics)on suspicion. I remember having symptoms enough to call an on-call GI doctor, but forget now what symptoms I had...but they did clear up after the antibiotics.
By the way, my surgeon gave me samples of Balneol (Hygenic Cleansing Lotion)at one of my follow up visits awhile after surgery and I eventually quit Calmoseptine and have used Balneol for 20 years. I certainly don't want to knock a site sponsor (and I know it is good at what it does), but I never go anywhere without this. There are times when burning gets out of control and it is only soothing for a short time....those are probably times that I should go back to Calmoseptine....but all in all it still works for me a lot of the time.
I don't know if any of this was helpful...but, I hope something was....and you're message had good information for me.
Daughter has Crohn's colitis - her first calprotectin was >2000, yep, 2000! The peds guys love the non-invasiveness of this test. She was 70 a month and a half ago. Whew. Doing well on Humira and MTX.

It is a newer test. Didn't exist for me as a marker.

My GI hasn't agreed to send one on me, with my pouch, though I've asked.
Wow, this post was over a year old! Lots has changed Smiler

I did have my calprotectin tested a couple more times since then -- my GI likes it.

In April I had C. diff and my calprotectin tested at 1334, an "all time" high for me. This is normal for anyone with C. diff infection, IBD or not.

Subsequent to treatment with Dificid (miracle drug), my calprotectin was 164 in May.

I haven't been tested since then but may do it when I go for a check up in November -- I'm curious to see if 164 if "baseline" for me or if that was still inflated from recent C. diff.
I believe that we j-pouchers often walk around with some chronic evel of inflammation. As one of my better docs once said to me "we need to treat the patients not the numbers". So, if you're at 5-6 bms a day (a number I have never ever achieved) I wouldn't worry about it.

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