Fecal Calprotectin is a non-invasive test of inflammation.  An elevated fecal calprotectin may assess severity and long term celiac outcomes.

Fecal calprotectin is a stool test to evaluate gut inflammation.  It is a first line test for Crohn’s and colitis.

Researchers looked at patients that had a fecal calprotectin test that were diagnosed with celiac disease between 2018 and 2023.  These patients also had follow-up calprotectin tests on average 103 months post-celiac diagnosis.

Seventeen months post-celiac diagnosis patients had a repeat endoscopy. Seventy-four percent of patients showed improved small intestine markers. Twelve patients developed complications or complicated celiac disease and twenty-one patients died.  

In this instance, complicated celiac disease means a diagnosis of refractory celiac.  Refractory celiac disease is persistent villous atrophy after 12 months on a strict gluten free diet.

These research findings suggest that patients with persistent high levels of fecal calprotectin have a more severe celiac disease type and poorer long term outcomes.  Researchers believe the persistent elevated calprotectin level may be driven by small bowel disease rather than problems in the large intestine.

Note this is a very small study at a single facility.  It is unclear if this research will hold up long term.**

The fecal calprotectin test is inexpensive and easy to run. It might be worth talking to your doctor about a fecal calprotectin test now and each time you see them, establishing a record.  If this research turns out to be accurate, having some historical data might influence the way they treat you.

Finally, celiac patients should have regular follow up appointments with their gastroenterologist.  Celiac.com has a great checklist for follow up if your doctor is clueless.  Check it out, here -> https://celiac.org/about-celiac-disease/treatment-and-follow-up/

Research article discussed above -> https://www.sciencedirect.com/science/article/pii/S1590865824010107