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First comprehensive guideline on using biomarkers for monitoring Crohn’s disease

New AGA guideline outlines reliable blood and stool tests to monitor inflammation that can reduce how often patients need invasive endoscopy.
Man getting blood test preparation in clinic
Man getting blood test preparation in clinic

We just released a new evidence-based guideline recommending the use of blood and stool-based biomarkers to help manage Crohn’s disease. The guideline was published today in Gastroenterology. 

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. 

AGA clinical guidance

Find the latest evidence-based recommendations for treating your patients.