Calprotectin stool test vs colonoscopy to monitor remission

I monitor my inflammation levels with calprotectin tests every 2-3 months. I believe the recommendation is at least once every 6 months but I don't like to wait that long (calprotectin rises in advance of a flare) as I want to catch and treat any flare-up early.

Besides that I'm required to do a colonoscopy at least once every 2 years for cancer screening purposes. I am in Europe and here you can do your scopes unsedated (at least in the few countries i have lived in). I've done it one time under fentanyl only (i.e. strong pain relief but i was still awake), and it was fine, but that was when i was in remission. Another time i tried unsedated when i was flaring (i wanted to watch the tv screen) - it was too painful to proceed so they sedated me. I have friends who did their routine 50-plus colonoscopy without sedation but they don't have IBD.

A calprotectin test will not detect cancer and, depending on where your inflammation, is located, may not accurately represent the inflammation in your colon. I have a "classic" type of UC in that the inflammation begins and is most severe in the rectum. I had a period of many scopes and calprotectin tests in a short time interval so that I know how to correlate my numbers with what's happening in my bowel. I wouldn't ever skip doing scopes completely as there is really no substitute for direct observation and biopsies. The calprotectin is more intended to monitor things in between scopes and give extra insight beyond the symptoms.

Post Edited (poopydoop) : 2/5/2023 9:57:54 AM (GMT-8)

C-scope is really the gold standard for evaluating mucosal conditions in the colon, and it can reach the terminal ileum, too. They used to be done in U.S. with the so-called "twilight sedation" combo Demerol + Versed. Then ca. 15 yrs ago researchers decided that those drugs shouldn't be administered to seniors owing to possible cognitive effects like lingering confusion post-scope. Beside that issue, gastroenterologists claimed that some patients undergoing c-scopes with only partial sedation would suddenly burst out yelling during the procedure from pain. That never happened to me under partial, but the D + V combo would leave me somewhat groggy for the following 24-36 hours. The medical centers in my urban area then began requiring total anesthesia for c-scopes around 2009. I'm not thrilled about having to get totally knocked out with Propofol so I try to space out c-scopes to every few years because my family medical history doesn't include colon cancer. (I do see gastro a couple times a year for thorough blood labs, including ESR & CRP. My flares have coincided especially with ESR increases.) / Old Hat (40+ yrs with left-sided UC; in remission taking Colazal)

That's interesting about the required anaesthesia Old Hat. I've never heard of anyone getting a full anaesthetic over here. Usually they administer fentanyl and midazolam (or another one of the benzo family).

poopydoop said...
That's interesting about the required anaesthesia Old Hat. I've never heard of anyone getting a full anaesthetic over here. Usually they administer fentanyl and midazolam (or another one of the benzo family).

Most switched to propofol because they can make more profit. I have horrible reactions after I get home and will never let another doctor force me to take propofil again. I'm demanding to go back to fentanyl and midazolam. Two different doctors didn't care propofol gives me suicidal thoughts and still made me take it. I did a lot of research into this and it's because patients wake up right away so they can boot you out the door and make more money with more patients. Ironically, I was always way more out of it after getting propofol.