Faecal parameters in the assessment of activity in inflammatory bowel disease

Background: Determination of inflammatory activity is helpful when assessing the efficacy of drugs in therapeutic trials and in facilitating management of individual patients with inflammatory bowel disease (IBD). Faecal parameters have been hypothesized to be more specific than non-faecal measurements in the assessment of intestinal inflammation. Methods: Review of the literature on faecal measurements in IBD. Results and conclusions: Leakage of various proteins and leukocyte products into the intestinal lumen can be assessed and quantified in stool specimens and serve as a measurement of inflammatory activity. Several of these faecal parameters are raised in patients with IBD. There is a considerable overlap between patients with active and those with inactive disease, however, and the correlation of the faecal parameters with disease activity indices is often low. The value of alpha(1)-antitrypsin measurement in faeces in the assessment of intestinal inflammation has been well established. Further studies in patients with IBD are needed to determine whether other faecal parameters, such as lactoferrin, honour necrosis factor alpha, PMN-elastase, lysozyme, leucocyte esterase, immunoglobulin A, among others, are more accurate or cost-effective than measurement of alpha(1)-antitrypsin in the stools of such patients.