Fecal Lactoferrin Measurements in Clinical Practice

Intestinal inflammation is a hallmark of the inflammatory bowel diseases (IBD), including ulcerative colitis and Crohn’s disease. These chronic autoimmune GI illnesses affect upwards of 3 million children and adults in the United States. Many of the symptoms in patients with IBD overlap with those observed in patients with irritable bowel syndrome (IBS), a discrete and likely pathogenically pleomorphic gastrointestinal illness. Nonetheless, there is a premium on making a distinction between IBD and IBS as their treatment differs significantly. Fecal lactoferrin testing is a non-invasive metric that can be used to help differentiate patients presenting with non-specific gastrointestinal symptoms as having either IBD or IBS. Previous data have demonstrated that fecal lactoferrin levels may also useful in tracking disease activity or assessing response to therapy. Several factors make lactoferrin a particularly useful biomarker: it is structurally stable and not sensitive to bacterial proteases in the intestinal lumen, it has a steady baseline with well-defined clinical cutoffs, and has broad applicability as it is reliable in virtually any scenario in which a clinician is trying to discern if a particular patient is presenting with an infectious, autoimmune, or inflammatory gastrointestinal disease. These attributes can be leveraged to provide improve health outcomes while decreasing the economic burden on the healthcare system.

Learning Objectives:

• Identify scenarios in which fecal lactoferrin testing may aid in diagnosis

• Recognize when fecal lactoferrin levels may be useful in tracking disease activity or assessing response to therapy

• Use fecal lactoferrin biomarkers as a first-step diagnostic strategy to minimize the need for scoping on certain patient populations, like pediatrics, for whom a more non-invasive diagnostic tool is beneficial