The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
A Meta-Analysis of the Utility of C-Reactive Protein, Erythrocyte Sedimentation Rate, Fecal Calprotectin, and Fecal Lactoferrin to Exclude Inflammatory Bowel Disease in Adults With IBS
Abstract
OBJECTIVES: Irritable bowel syndrome (IBS) is viewed as a diagnosis of exclusion by most providers. The aim of our study was to perform a systematic review and meta-analysis to evaluate the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin, and fecal lactoferrin to distinguish between patients with IBS and inflammatory bowel disease (IBD) and healthy controls (HCs). METHODS: A systematic online database search was performed. Included studies were prospective, adult, diagnostic cohort studies with any of the four tests. The means and s.d. values of biomarker logarithms were estimated based on studies that gave medians and either confidence intervals for the median, interquartile ranges, or ranges. We used a Naive Bayes approach to estimate the probability of being a HC, having IBS, or having IBD based on the biomarker values. RESULTS: Systematic review identified 1,252 citations. After cross-referencing medical subject headings, detailed evaluation identified 140 potentially relevant journal articles/abstracts for CRP, ESR, calprotectin, and lactoferrin of which 4, 4, 8, and 2 fulfilled our inclusion criteria, respectively. None of the biomarkers reliably distinguished between IBS and healthy controls. At a CRP level of ≤0.5 or calprotectin level of ≤40 μg/g, there was a ≤1% probability of having IBD. Individual analysis of ESR and lactoferrin had little clinical utility. CONCLUSION: CRP and calprotectin of ≤0.5 or 40, respectively, essentially excludes IBD in patients with IBS symptoms. The addition of CRP and calprotectin to symptom-based criteria may improve the confident diagnosis of IBS.
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Cites
Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & the PRISMA Group* (2009) · Annals of Internal Medicine · doi:10.7326/0003-4819-151-4-200908180-00135 · Cited by 37,554
Longstreth, G. F., Thompson, W. G., Chey, W. D., Houghton, L. A., Mearin, F., & Spiller, R. C. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.061 · Cited by 4,856
Self-citationWhiting, P., Rutjes, A. W., Reitsma, J. B., Bossuyt, P. M., & Kleijnen, J. (2003) · BMC Medical Research Methodology · doi:10.1186/1471-2288-3-25 · Cited by 3,592
AGA technical review on irritable bowel syndrome.
Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002) · Gastroenterology · doi:10.1053/gast.2002.37095 · Cited by 1,384
An Evidence-Based Position Statement on the Management of Irritable Bowel Syndrome
American College of Gastroenterology IBS Task Force (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2008.122 · Cited by 694
Halpin, S. J., & Ford, A. C. (2012) · American Journal of Gastroenterology · doi:10.1038/ajg.2012.260 · Cited by 607
Chey, W. D., Nojkov, B., Rubenstein, J. H., Dobhan, R. R., Greenson, J. K., & Cash, B. D. (2010) · American Journal of Gastroenterology · doi:10.1038/ajg.2010.55 · Cited by 175
Self-citationLanghorst, J., Junge, A., Rueffer, A., Wehkamp, J., Foell, D., Michalsen, A., Musial, F., & Dobos, G. J. (2009) · The American Journal of Gastroenterology · doi:10.1038/ajg.2008.86 · Cited by 167
Carroccio, A., Brusca, I., Mansueto, P., Soresi, M., D'Alcamo, A., Ambrosiano, G., Pepe, I., Iacono, G., Lospalluti, M. L., La Chiusa, S. M., et al. (2011) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2011.07.030 · Cited by 75
Cited by
Lamb, C. A., Kennedy, N. A., Raine, T., Hendy, P. A., Smith, P. J., Limdi, J. K., Hayee, B., Lomer, M. C. E., Parkes, G. C., Selinger, C., et al. (2019) · Gut · doi:10.1136/gutjnl-2019-318484 · Cited by 2,346
ACG Clinical Guideline: Management of Irritable Bowel Syndrome
Lacy, B. E., Pimentel, M., Brenner, D. M., Chey, W. D., Keefer, L. A., Long, M. D., & Moshiree, B. (2021) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001036 · Cited by 893
Self-citationFord, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020) · The Lancet · doi:10.1016/s0140-6736(20)31548-8 · Cited by 818
Calprotectin: from biomarker to biological function
Jukic, A., Bakiri, L., Wagner, E. F., Tilg, H., & Adolph, T. E. (2021) · Gut · doi:10.1136/gutjnl-2021-324855 · Cited by 500
Avan, A., Tavakoly Sany, S. B., Ghayour‐Mobarhan, M., Rahimi, H. R., Tajfard, M., & Ferns, G. (2018) · Journal of Cellular Physiology · doi:10.1002/jcp.26791 · Cited by 182
Metadata
- Authors
- Menees, S. B., Powell, C., Kurlander, J., Goel, A., & Chey, W. D.
- Venue
- American Journal of Gastroenterology
- Published
- 2015-03
- Volume
- 110
- Issue
- 3
- Pages
- 444-454
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2077187057
- Cited by
- 391
- References
- 9
- FWCI
- 4.53
- Type
- journal article
- Language
- en
- Open access
- closed
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- CoChat. (2026). Citation check: A Meta-Analysis of the Utility of C-Reactive Protein, Erythrocyte Sedimentation Rate, Fecal Calprotectin, and Fecal Lactoferrin to Exclude Inflammatory Bowel Disease in Adults With IBS. https://app.cochat.ai/papers/10.1038/ajg.2015.6
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- Menees, S. B., Powell, C., Kurlander, J., Goel, A., & Chey, W. D. (2015). A Meta-Analysis of the Utility of C-Reactive Protein, Erythrocyte Sedimentation Rate, Fecal Calprotectin, and Fecal Lactoferrin to Exclude Inflammatory Bowel Disease in Adults With IBS. American Journal of Gastroenterology. https://doi.org/10.1038/ajg.2015.6
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
