Faecal parameters in the assessment of activity in inflammatory bowel disease

Background: Determination of inflammatory activity is helpful when assessin g the efficacy of drugs in therapeutic trials and in facilitating managemen t of individual patients with inflammatory bowel disease (IBD). Faecal para meters have been hypothesized to be more specific than non-faecal measureme nts in the assessment of intestinal inflammation. Methods: Review of the li terature on faecal measurements in IBD. Results and conclusions: Leakage of various proteins and leukocyte products into the intestinal lumen can be a ssessed and quantified in stool specimens and serve as a measurement of inf lammatory activity. Several of these faecal parameters are raised in patien ts with IBD. There is a considerable overlap between patients with active a nd those with inactive disease, however, and the correlation of the faecal parameters with disease activity indices is often low. The value of alpha(1 )-antitrypsin measurement in faeces in the assessment of intestinal inflamm ation has been well established. Further studies in patients with IBD are n eeded to determine whether other faecal parameters, such as lactoferrin, ho nour necrosis factor alpha, PMN-elastase, lysozyme, leucocyte esterase, imm unoglobulin A, among others, are more accurate or cost-effective than measu rement of alpha(1)-antitrypsin in the stools of such patients.