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Abstract Inflammatory bowel diseases (IBD) including ulcerative colitis (UC) and Crohn’s disease (CD) are organic inflammatory diseases, caused by chronic mucosal inflammation of the gasrtointetinal tract. IBD occurs more in people of Caucasian and Ashkenazic Jewish origin than in other racial and ethnic subgroups. They are typically characterized by variable disease activity, often with repeated periods of intermittent disease activity and remission. Irritable bowel syndrome (IBS) is quite prevalent in the general population (from 5% to 20%) and represents the functional gastrointestinal (GI) disorder most frequently encountered in primary and secondary care. IBS is characterised by abdominal discomfort, pain and changes in bowel habits (constipation and/or diarrhea). As the presenting manifestations of IBD and IBS are similar and can include diarrhea, abdominal pain and bloating, obtaining a clinical diagnosis can be difficult, and further invasive diagnostic procedures may be required in order to obtain a confirmed diagnosis. Fecal biomarkers provides a non invasive diagnostic tool for identification of those patients. Fecal biomarkers are acute phase proteins produced by inflamed mucosa that can help to gain an objective measurement of disease activity as symptoms are often subjective and also help to avoid invasive procedures which are often a burden to the patient and the health care system. Fecal lactoferrin assay is one of those fecal biomarkers that is characterized by its high sensitivity and specificity in identification of patients with inflammatory bowel disease from healthy subjects. The aim of this study was to assess the fecal lactoferrin levels in patients with IBD and to compare them with levels obtained from patients with IBS and normal subjects to detect its sensitivity and specificity as a non invasive biomarker in identification of such patients. Our study also included measurement of FLA levels at different stages of inflammatory bowel disease activity to detect its role in assessment of disease severity. This study was carried on 50 subjects classified into 3 groups: Group I was 30 patients with inflammatory bowel disease, Group II was 10 patients with irritable bowel syndrome, Group III was 10 healthy subjects served as control group. This study showed that FLA levels were highest in patients with IBD in comparison with IBS patients and healthy group. FLA levels also correlated significantly with disease severity in patients with IBD were higher levels of FLA were found in patients with severe UC or Crohn`s disease. At cutoff value 37 ug/ml FLA showed 96.7% sensitivity and 100% specificity in identification of patients with IBD from those with IBS. At cutoff value 7.2 ug/ml FLA showed 100% sensitivity and specificity in identification of patients with IBD from healthy subjects. On the other hand, FLA wasn`t found to be useful in identification patients with IBS from healthy subjects (sensitivity 90%, specificity 40%). |