Background and study aims: Inflammatory bowel disease (IBD) is a chronic inflammato­ry and destructive disease of the bowel wall. Chronic inflammation is associated with ulcerations, strictures, perforations and is a risk factor for dysplasia and cancer. To reduce these long-standing complications, IBD patients are continuously in a need for treatment and monitoring. Primary health care centers lack specific IBD management facilities although they receive a reasonable number of IBD patients. Markers, such as ESR, CRP, fecal calprotectin (FC) have been widely used as noninvasive parameters for IBD monitoring. The aim of the current study was to evaluate readily available non-invasive tests (FC, ESR, Platelets, serum total proteins, serum albumin and hemoglobin level) in predicting IBD activity and severity in the primary health care‎‎‎.
Patients and Methods: This prospective study included 96 newly diagnosed IBD patients. Patients from many primary health care ‎centers covering the landscape of Kafr-Elshikh governorate in the North of Egyptian Nile delta after giving ‎complete history, clinical examination, and laboratory investigation were referred to IBD clinic at ‎Kafrelsheikh University Hospital for assessment and ileoclonoscopy with biopsies‎.‎
Results: Seventy-eight (81.2%) patients were ulcerative colitis and 18(18.8%) were Crohn's disease, with mean age ‎was 34.40 and 30.94 years respectively (P 0.380).FC, serum total proteins, ESR and HB level showed ‎statistically significant difference between baseline levels and levels at time of remission. However, platelet ‎count and serum albumin were not statistically different. The mean FC level at the time of diagnosis was ‎‎823.61±545.457μg/mg and after remission was 165.18±202.255μg/mg (P 0.000)‎‎‎‎.
Conclusion: Markers (FC, ESR, serum total proteins and HB level) can be used as non-invasive markers for monitoring ‎IBD activity and severity in the primary health care centers. Fecal calprotectin correlate with endoscopic ‎disease activity. Furthermore, the initial level of FC is a predictor of early dysplasia in ulcerative colitis ‎patients‎ ‎‎.