PMO-015 What is the clinical relevance of a mildly elevated faecal calprotectin detected in new referrals to the gastroenterology clinic?

Introduction Analysis of faecal calprotectin (FC) is a non-invasive method for differentiating IBS from IBD. As a screening test, a normal FC has been employed to support a diagnosis of IBS, thereby avoiding invasive endoscopy in the patient cohort. We sought to investigate the diagnostic yield on subsequent colonoscopy in patients with mildly elevated FC and lower GI symptoms. Methods Between November 2009 and November 2010, all patients with a FC value of 50–100 μg/g of stool (normal 100 ug/g stool, were known cases of IBD, had a history of NSAID intake, positive stool cultures, or any “alarm” GI symptoms. A similar cohort was identified with age & sex matched controls with FC values Results 216 patients were identified with a FC of 50–100 μg/g. After exclusion criteria, 158 patients remained. Of these 82 underwent complete colonoscopy (mean age 36.7, M:F 1:2.2) which was abnormal in only six cases (three cases of a single adenoma Conclusion In our population, the diagnostic yield of colonoscopy in patients below the age of fifty with new lower GI symptoms and a mildly elevated FC is very low. If our data can be replicated in a prospective manner, we suggest that invasive colonoscopy can be safely avoided in this cohort and interval FC analysis may be more appropriate. Competing interests None declared.