Fecal calprotectin in pediatric gastrointestinal diseases: Pros and cons

Table 4 Factors influencing inconsistent levels of fecal calprotectin in various pediatric gastrointestinal disorders

Factors	Influence on fecal calprotectin levels
Demographic factors	Age; higher in infants and younger children
Dietary factors	The diet that increases FC includes inflammatory Foods (such as saturated fats, refined sugars, and processed ingredients), food Sensitivities and Allergies, Alcohol and Caffeine, and dehydration. The diet that decreases FC includes hydration, high fiber intake (such as fruits, vegetables, whole grains, and legumes), Omega-3-containing foods (such as fatty fish (e.g., salmon, mackerel, sardines), flaxseeds, and walnuts), and prebiotics and probiotics
Medication usage	Drugs that could increase FC levels: Prolonged use of NSAIDs, antibiotics, PPIs, and antidiarrheal medications such as loperamide. Drugs that could reduce FC levels: Corticosteroids, immunosuppressants, such as azathioprine, and methotrexate, biological agents like infliximab and adalimumab, and Probiotics
Gastrointestinal conditions	Gastrointestinal bleeding, concurrent infections
Disease-specific factors	Disease etiology (e.g., IBD vs functional GI disorders like IBS)
Disease severity	Severity of inflammation (e.g., active inflammation in acute infectious gastroenteritis or IBD flare-ups)
Host immune responses	Genetic factors, individual susceptibility to inflammation
Methodological considerations	Sampling timing, assay methodologies
Lifestyle factors	Medication usage, dietary habits

FC: Fecal Calprotectin; GI: Gastrointestinal; IBD: Inflammatory bowel disease; IBS: Irritable bowel syndrome; NSAIDs: Nonsteroidal anti-inflammatory drugs; PPI: Proton pump inhibitors.