Calprotectin test at 5127

Hi, does 5127 calprotectin indicate a very high level of inflammation only in the colon? Or could another problem like the gallbladder effect the score? I've had cramps and heartburn more than usual too.

I've flared a bit a couple months ago, got Covid which did a number on my bowels, and have also been taking ferrous sulfate for low iron and hemoglobin. So I'm having an upper and lower scope next month. I'm wondering how far the endoscope goes and if it will show the gallbladder and bile glands.

Can't wait 🤤 for the scopes

Are you on any meds for UC?
The calprotectin measures inflammation in the intestinal tract. I read that normal range is 20 - 200 micrograms per milligram. You obviously have a high number count.

An upper endoscopy would not be able visualise the gallbladder or bile ducts.

Why do you suspect a gallbladder issue? Have any blood tests suggested that to be an issue, or is it based on your discontinued discomfort?

There are 4 methods for testing...an ultrasound, MRCP HIDA and ERCP.

The ERCP is most invasive, and I suggest it only if you have a blockage, stones or stricture.

The HIDA scan uses an radioactive tracer to highlight the liver, gallbladder and bile ducts.

An MRCP is an MRI that uses a contrast that highlights the liver, gallbladder, bile ducts, pancreas, and pancreatic duct. 

If you're waiting a long while for an MRCP or HIDA then an ultrasound would at least give some insight regarding possible gallstones.

q

I will have a look at my liver tests. Maybe they are ok, and I'm reading to much into it. I have been taking the generic Asacol (2400) mg daily for 20 years now. Can't go higher, but my Dr. Says it's still working for me. We just want to rule out ulcers in the esophagus or stomach. Then of course the entire colon.

I tend to use Dr. Google too much....my symptoms seem to mimick those of family members who have had gallstones. And I have been eating poorly over the past year. I call it "Covid Diet"..a ton stress + chocolate + cake. And not enough sleep.

Two weeks ago my bilirubin was 8...normal and Gamma GT was High at 31
In January my hemoglobin was low at 111, now in March it's 118
So I'm probably flaring somewhere. My stools are now formed, but coated in mucus some of the time. No visible blood.
Q- yes I do occasionally use Pentassa enemas, and have in the past month. Luckily they aren't expired yet!
It's that heartburn that I was getting...totally not me, that lead my Dr. To do an upper scope. Guess I'll find out!

Update:

In the last week I have only been able to pass liquid mucus and spits of brown sediment like the end of a colonoscopy prep. Only one tiny almost formed stool. I've stopped taking the iron pills now for about 5 days. I am bloated and crampy at times, but can pass some gas.

I've used the retention enemas for 3 nights now. I don't know if that's making a difference. I go for a colonoscopy in 2 weeks and have to do the prep. Yuk 🤤
My concerns are if I have some kind of blockage, and what can I do about it, or do I need to inform my GI Dr?

I’m with Quincy on the ERCP. My understanding is…that level of endoscopy is mainly for the treatment (fixing) an already diagnosed, known problem. An MRCP was used at John’s Hopkins to look for said problems in my bile ducts, stones, pancreas, etc. They diagnosed me with pancreatic divisum (a birth defect of the bile ducts). Many people have this their whole lives and are never the wiser. If the MRCP had shown a problem that needed addressing, that would require an ERCP.

My GI ordered an ERCP as a fishing expedition. I cancelled the test. He and I still need to discuss that cancellation. If an MRCP is good enough for JH, it should be good enough for him.

Good luck on your upcoming test.

Does calprotectin also measure colon inflammation? My Quest report gave me a reading of 12 but stated persons with Crohn’s or UC could have readings thousands of times higher.
I was diagnosed with moderate pan colitis in 2/2020. Started with mesalamine and prednisone.
12/1/20 I started Humira and continued mesalamine.
I also had extremely low inflammation readings for 2 others tests.
I’m wondering…do I even have UC (symptoms started within 2 weeks of my mom passing) or do these good lab results means the meds are working? See doc in August and have these Qs.
Sed Rate = 2.
C-Reactive Protein = 1.0