Inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) are two chronic conditions associated with diarrhea and abdominal pain, and these symptoms are among the most common reasons that patients seek medical advice.
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Fecal lactoferrin is a biomarker of serious gastrointestinal inflammation. Fecal lactoferrin is elevated in association with Inflammatory Bowel Disease (IBD) such as Ulcerative Colitis (UC) or Crohn's Disease (CD), but NOT Irritable Bowel Syndrome (IBS). Therefore, assessment of fecal lactoferrin levels enables distinction between IBD and non-inflammatory IBS. Such distinction is critical because, although both IBD and IBS may share some common symptoms such as diarrhea, abdominal cramping and weight loss, the diseases are treated quite differently. IBD may become life threatening, requires life-long treatment and possibly surgery. In contrast, IBS is often effectively treated with dietary restrictions, stress reduction and medication.
Gastrointestinal inflammation associated with IBD is associated with increased infiltration of activated neutrophils into the mucosa and increased release of lactoferrin into the gut. Patients with inflammation of the GI tract, such as IBD (but not IBS), exhibit elevated lactoferrin concentrations in the feces.
Clinical studies have shown that fecal lactoferrin levels of healthy persons are similar to IBS patients, but markedly increased in patients with active IBD. Patients with IBD oscillate between active and inactive disease states, and fecal lactoferrin levels increase 2-3 weeks prior to onset of clinical symptoms. During remission and effective treatment, fecal lactoferrin decreases significantly. Therefore disease activity, and efficacy of treatment can be monitored by following fecal lactoferrin levels.