Millions of people in the U.S. suffer from inflammatory bowel disease (IBD) and less seriously from irritable bowel syndrome (IBS).
IBD gets worse over time, and its severe symptoms affect the quality of life of people with the disease. The two most common inflammatory bowel diseases are ulcerative colitis and Crohn’s disease.
IBS is a disorder that affects the colon’s muscle contractions. Intestinal inflammation is not a symptom of IBS, although abdominal pain may feel similar to the patient.
Chronic abdominal pain and diarrhea are symptoms common to both IBS and IBD, making differentiation between the two disorders difficult, and often resulting in unnecessary testing and delayed treatment.
IBD or IBS?
Anyone with chronic bowel problems should be considered a candidate for lactoferrin testing. But you should strongly consider lactoferrin testing for a patient suspected of IBD or IBS or an IBD patient suspected of active disease.
Suspected IBS/IBD patient
Detecting elevated lactoferrin levels can help to differentiate active IBD from IBS.
Intestinal inflammation distinguishes active Inflammatory Bowel Disease (IBD) from Irritable Bowel Syndrome (IBS). A positive test result for elevated fecal lactoferrin in persons who have tested negative for infectious etiologies should alert the physician to possible IBD, which warrants further testing. A negative result may signal a functional disorder like IBS, which is non-inflammatory.
Diagnosed IBD patient
Measuring lactoferrin levels can help to indicate the degree of IBD severity.
Levels of fecal lactoferrin correlate with levels of IBD activity and may be used as an indicator of mucosal healing.
If a patient is already diagnosed with IBD, testing lactoferrin levels can help predict a flare up, as lactoferrin levels rise before other symptoms may appear. Lactoferrin testing can also help determine if a disease management plan is effective.
Lactoferrin in pediatric IBD care
Approximately 20% of IBD patients are diagnosed in childhood, yet many methods of monitoring IBD activity are difficult for both the parents and the child.
Common concerns about diagnostic tools
- Parents may be reluctant for their child to undergo repeated colonoscopy given the perceived risk of the procedure.
- Routine laboratory measurement of serum biomarkers requires phlebotomy, which is invasive and often provokes severe anxiety.
- Several clinical indices depend on patients describing their symptoms. Young children may not be able to communicate symptoms clearly.
Lactoferrin in obstetric IBD care
Diagnosis during childbearing years
IBD is most often diagnosed in the second through fourth decades of life—a period that coincides with likely childbearing years for female patients. Twenty-five percent of patients conceive for the first time after their diagnosis.
Pregnancy & IBD
Pregnancy with IBD can be challenging. Research indicates that women with IBD are at a higher risk for
- developing gestational diabetes,
- delivering preterm, and
- requiring cesarean section.
The majority of patients with active disease will continue to have it throughout pregnancy, yet some IBD medications are contraindicated during gestation, making treatment more difficult.
To ensure a successful pregnancy, close monitoring and management of IBD during the conception period and pregnancy is essential. Lactoferrin testing can help to non-invasively monitor disease activity and guide treatment decisions for women during this time.