Fecal Calprotectin Test

Overview

A fecal calprotectin test is a simple stool (poo) test. It measures how much calprotectin is in your sample. Calprotectin is a protein that white blood cells release when there is inflammation (swelling and irritation) somewhere in your bowel. A low level usually means your bowel is not inflamed. A high level means there is inflammation somewhere, and your doctor will want to find out why. The test does not tell you which condition you have. It is a clue that helps your doctor decide what to do next. It is often used to tell the difference between inflammatory bowel disease (IBD, such as Crohn's disease or ulcerative colitis) and irritable bowel syndrome (IBS), which does not cause inflammation.

Yes. It is a very common test in general practice and hospital clinics. It is cheap, safe and easy to do, so doctors use it a lot when someone has ongoing bowel symptoms.

It can be done at any age, from young children to older adults. It is used most often in people with ongoing diarrhoea, tummy pain, or a change in bowel habit, and in children who are not growing or gaining weight as expected.

Symptoms

Common symptoms

• Loose stools or diarrhoea that keeps coming back over weeks
• Tummy pain or cramping
• An urgent need to open your bowels
• Needing to go to the toilet often, sometimes at night
• Blood or mucus (slime) in your poo
• Feeling bloated or windy
• Tiredness or low energy

Symptoms in children

• Tummy pain that keeps returning
• Loose poo or diarrhoea
• Poor weight gain or slower growth than expected
• Blood in the nappy or toilet
• Being more tired or irritable than usual
• Not wanting to eat

Symptoms in older adults

• A new or lasting change in bowel habit
• Blood in the poo, or bleeding from the bottom
• Losing weight without trying
• Tummy pain or discomfort
• Feeling very tired, or short of breath from low iron levels

Causes

Main causes

• Inflammation in the bowel, such as Crohn's disease or ulcerative colitis (types of inflammatory bowel disease)
• Bowel infections, including some that clear up on their own
• Irritation from some medicines, such as certain anti-inflammatory painkillers
• Inflammation elsewhere in the gut, such as in the stomach or small bowel
• In children, inflammation linked to conditions such as coeliac disease or food allergies
• Blood in the sample, including from piles (haemorrhoids) or a slight bleed, which can raise the reading

Risk factors

• A close family member with inflammatory bowel disease
• Long-lasting or repeated bowel symptoms
• Recent travel or a recent bout of food poisoning
• Regular use of certain painkillers or other medicines
• Being a child or teenager with poor growth and bowel symptoms

When to see a doctor

See a doctor urgently if:

• Blood in your poo, or black tarry poo
• Losing weight without trying
• Severe or worsening tummy pain
• A high temperature with tummy pain
• Signs of dehydration, such as very dark urine, dizziness on standing, or passing very little urine

Book a routine appointment if:

• Diarrhoea or loose poo lasting more than two to four weeks
• Tummy pain that keeps coming back
• A change in your normal bowel habit that lasts
• Feeling bloated, windy or uncomfortable most days
• In children: poor weight gain, tummy pain or loose poo that does not settle

Diagnosis

There is nothing to diagnose from the test itself — it is one piece of information. Your doctor will ask about your symptoms, your medicines, your family history and your travel, then decide whether a stool test is helpful. You collect a small sample of poo at home in a pot provided by your GP surgery or clinic, label it with your name and the date, and return it as instructed — usually within a day or two. The lab measures the calprotectin level and sends a result back. Your doctor then combines that result with your symptoms to decide what happens next. Levels are usually described as normal, borderline, or raised, and the exact cut-offs vary between laboratories, so ask what your own result number means.

Tests that may be done

• Fecal calprotectin (the stool test itself)
• Other stool tests, such as checking for infection or blood
• Blood tests, including a full blood count and markers of inflammation
• Coeliac disease testing, where relevant
• A camera test of the bowel (colonoscopy or sigmoidoscopy) if results or symptoms suggest it is needed
• Scans such as ultrasound or MRI in some cases

Treatment

The test itself needs no treatment. Treatment depends entirely on what is found to be causing your symptoms. If the result is normal, your doctor may focus on things like diet, stress and managing irritable bowel syndrome. If the result is raised, the next step is usually to look for the cause — this might be treating an infection, reviewing medicines, or seeing a specialist for further tests.

Self-care at home

• Keep a simple diary of your symptoms, what you eat, and when things are worse — this helps your doctor.
• Drink enough fluids, especially if you have diarrhoea.
• Eat regular meals and avoid foods you have noticed clearly make symptoms worse.
• Check with a pharmacist before buying painkillers, as some can irritate the bowel.
• Get plenty of rest and gentle activity — both help you feel more in control.
• Attend follow-up appointments and hand in samples on time so nothing is delayed.

Medical treatments

Treatment is aimed at the cause. For an infection, you may need no treatment at all, or your doctor may prescribe something specific to the bug found. If a medicine you take is thought to be irritating your bowel, your doctor may suggest an alternative. If inflammatory bowel disease is found, specialists use medicines that calm inflammation and keep it away — often started as tablets or liquids, with other options available if needed. Some people need medicines given into a vein or under the skin, and some need procedures to look inside the bowel. Your specialist team will explain the options, the benefits and the side effects, and will agree a plan with you. Never start, stop or change any medicine without speaking to your doctor or pharmacist first.

When is surgery considered?

Most people with bowel symptoms never need surgery. Surgery may be discussed if someone is found to have inflammatory bowel disease that is not controlled well with medicines, or if there is a complication such as a narrowing or a collection of pus. This is a decision for a specialist team, and it is only considered after other options have been tried.

Living with this condition

Waiting for a stool test result, or living with ongoing bowel symptoms, can be worrying and can make ordinary days harder — planning journeys, eating out, or sitting through a meeting can all feel stressful. It helps to know that a calprotectin test is a quick, low-risk way to get clearer information, and that many people turn out to have a manageable condition like irritable bowel syndrome rather than anything serious. Write down your questions before appointments and take someone with you if you can.

Lifestyle tips

• Keep a simple symptom and food diary for a few weeks.
• Build in regular gentle exercise, such as walking, which can help digestion and mood.
• Try to keep to regular meal times and avoid very large or very late meals.
• Limit alcohol and caffeine if you notice they make symptoms worse.
• Make sure you know where toilets are when you go out, so you feel less anxious.
• Get enough sleep — tiredness makes bowel symptoms feel worse.

Diet and exercise

There is no special diet before a calprotectin test — you eat and drink as normal. If your symptoms continue, your doctor or a dietitian may suggest changes. Some people find a diet lower in certain hard-to-digest sugars helps, and this is best done with professional guidance so you still get all the nutrients you need. Fibre and fluid are important for most people, but if you have a narrowing in the bowel or a flare of inflammation, your team may advise something different. Gentle, regular movement — walking, swimming, cycling — supports gut health and mood. If you are losing weight or eating less because of symptoms, tell your doctor.

Mental health and emotional wellbeing

Bowel symptoms and waiting for test results can cause real worry, and anxiety can in turn make symptoms feel worse. This is very common and nothing to be embarrassed about. Talk to your GP or practice nurse about how you are feeling — support such as talking therapies is available and can help a lot. If you ever feel overwhelmed or hopeless, or have thoughts of harming yourself, please reach out for help straight away: contact your local emergency number, a crisis support line in your country, or the nearest emergency department. You do not have to cope alone.

Prevention

The test itself is not something you prevent, and bowel conditions can't always be prevented. You can, though, make it more likely that a test gives a clear answer: tell your doctor about all your medicines, hand the sample in promptly, and mention recent travel, antibiotics or infections. Looking after your general health — eating well, staying active, not smoking, and keeping alcohol within sensible limits — supports your gut and your overall wellbeing.

Screening programmes

There is no general screening programme that uses fecal calprotectin. It is used when you have symptoms, not as a routine check for everyone. Bowel cancer screening programmes do exist in many countries, usually using a different stool test for hidden blood, and these are offered by age group — check with your local health service to see what applies where you live.

Complications

If left untreated

• If a test is put off, inflammation in the bowel may be found later rather than sooner.
• Ongoing inflammation can lead to anaemia (low iron in the blood), tiredness, or poor growth in children.
• Long-term inflammation can sometimes cause narrowing of the bowel or other problems, which are easier to manage when found early.
• Untreated bowel symptoms can affect work, school, sleep and mood.

Long-term outlook

The outlook is good for most people. A fecal calprotectin test is a quick way to get useful information, and in many cases it shows there is no inflammation at all — which is reassuring. If inflammation is found, there are effective treatments and specialist teams who manage these conditions well, and most people go on to live full, active lives. The important thing is to get symptoms checked and to keep in touch with your healthcare team.

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