Biomarkers are blood or stool tests that can give more information on an underlying disease process. In the context of IBD, biomarkers such as C-reactive protein (CRP) in blood and fecal calprotectin (FCP) in stool, can measure levels of inflammation. These levels can help you assess whether a patient’s Crohn’s disease is active or in remission.
AGA recommends the use of biomarkers in addition to colonoscopy and imaging studies.
For patients in remission:
- Check CRP and FCP every six to 12 months.
- These tests work best if CRP and FCP levels have previously matched with disease activity seen on endoscopic assessment.
For patients experiencing active symptoms:
- Check CRP and FCP every two to four months for patients experiencing an increase in symptoms (diarrhea and abdominal pain) to guide treatment adjustments.
- Before making any major treatment plan changes, consider repeating endoscopic or radiologic assessments.
For patients after surgery:
- FCP may be useful to monitor patients at low risk for disease recurrence.
- However, radiologic or endoscopic assessment should be performed when a post-operative recurrence is suspected rather than relying on biomarkers.