Fecal Biomarkers For Gastrointestinal Disease

Be sure to also review my post Screening Tests For Colorectal Cancer
Posted on September 9, 2018.

This post consists of excerpts from Resources (1): Update on clinical and research application of fecal biomarkers for gastrointestinal diseases (2017):

Here are excerpts from Resource (3), Update on clinical and research application of fecal biomarkers for gastrointestinal diseases (2017):

Core tip: There is a general inclination of clinicians as
well as pathologists’ to consider fecal biomarkers due
to its non-invasivity. There are multiple types of fecal
biomarkers in clinical use and under exploration for
potential clinical use in future. It includes biomarkers for
evaluating inflammatory bowel disease (e.g., calpro­tectin,
lactoferrin), for evaluating colorectal cancer, malabsorption
and eosinophilic protein for allergic gastroin­testinal
diseases. In this review we have analyzed the current
status in terms of their practical utilization of fecal biomarkers with established indications and those which are under various stages of investigation.

Fecal biomarkers can be subdivided into following types based on their clinical application.

Markers of inflammatory bowel disease

These include inflammation related proteins, released
during an inflammatory process in the gastrointestinal
(GI) tract (e.g., calprotectin) or antimicrobial peptides
(e.g., lactoferrin).

Biomarker of colorectal cancer

These are found in undifferentiated tissues and cells
with increased expression in rapid turnover of such
cells, e.g., M2-pyruvate kinase.

Biomarkers for evaluation of malabsorption

Multiple markers are identified; most are undigested
food particles like fecal fat globules, enzymes like α1antitrypsin
and elastase for malabsorption assessment.

Biomarker for GI allergic disease

Eosinophil related proteins are either released by or
related to eosinophils and have application in assessing
allergic and parasitic infestation of GI tract.

Biomarkers of gut health

This is an interesting group of biomarkers which with
point toward the overall health of the gut mucosa.
These biomarkers assess the integrity of gut barrier
proteins and microbial fermentation products which
are produced while fermentation of dietary particles by
bacteria produces various chemicals, few of which such
as short chain fatty acids, are used as biomarkers.

This review is divided in two parts, in part one we have aimed to include diagnostic accuracies for the established markers in clinical use and in second part the clinical
applications of fecal biomarkers under investigation for GI diseases are discussed.

Currently, apart from the fecal markers of inflammation
there is not enough literature regarding fecal biomarkers clinical utility in other GI diseases or health. For example eosinophilic proteins have the potential to be used as disease markers for allergic states and parasitic infestations; very common in developing country. But these markers require more studies to better understand their roles in diseased states. Another advan­tage of these markers will be that they will provide more insight into the cause of disease. Furthermore as
we are in an era of preventive medicine markers which can pick early changes in gut health are required so the patients screened out before developing a diseased state.

In conclusion development of fecal biomarker and establishment of their clinical and diagnostic utilities is a developing field with a lot of promise, but we still need more research to validate these findings.


(1) Update on clinical and research application of fecal biomarkers for gastrointestinal diseases [PubMed Abstract] [Full Text HTML] [Full Text PDF].  World J Gastrointest Pharmacol Ther. 2017 Feb 6;8(1):39-46. doi: 10.4292/wjgpt.v8.i1.39.

(2) Screening Tests For Colorectal Cancer
Posted on September 9, 2018 by Tom Wade MD

This entry was posted in Family Medicine, Gastroenterology, Internal Medicine. Bookmark the permalink.