{"id":3854,"date":"2025-07-28T15:00:51","date_gmt":"2025-07-28T15:00:51","guid":{"rendered":"https:\/\/cms.core-way.de\/?p=3854"},"modified":"2025-09-01T14:34:43","modified_gmt":"2025-09-01T14:34:43","slug":"inflammation-marker-for-ced","status":"publish","type":"post","link":"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/","title":{"rendered":"Inflammation markers in Crohn's disease and ulcerative colitis"},"content":{"rendered":"<p>In chronic inflammatory bowel disease, inflammatory markers such as the <strong>C-reactive protein (CRP)<\/strong> and the <strong>fecal calprotectin<\/strong> from diagnosis to monitoring the course of the disease. Nevertheless, the laboratory markers mentioned can be used to diagnose IBD <strong>Not ruled out with certainty<\/strong> or<strong> proven <\/strong>can be detected. In addition, CRP values do not allow any clear conclusions to be drawn about disease activity, but can be used in individual cases for <strong>Therapy monitoring<\/strong> can be helpful. In this article you can find out more about the laboratory markers CRP and calprotectin.<\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/lh7-rt.googleusercontent.com\/docsz\/AD_4nXfa3NTJKxxzyzgXr0xQjiFyBz5Bf7qo_5_F14tAtB8sIrxIOipCY-G-jV4MAuopRc7_TCpftTVn7IGBix663fkFiKHRcbeEj0vVcYfAsLAJu2t8T1c539lEAbffQFIaTF81VRF92g?key=4zEtIf4CrrGb5VzWCZbIgw\" alt=\"A woman with brown, curly hair, wearing a white coat and looking through a microscope. The microscope stands on a table on which there are other microscopes and beakers. The woman is in a laboratory. The picture symbolizes research and inflammation markers. The inflammation markers are important for the diagnosis and monitoring of the course of Crohn&#039;s disease and ulcerative colitis.\"\/><\/figure>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-edb63213\"><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Warum_kann_durch_die_genannten_Entzundungsmarker_eine_CED_nicht_eindeutig_nachgewiesen_werden\" >Why can't IBD be clearly detected by the inflammation markers mentioned?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#C-reaktives_Protein_CRP_als_Entzundungsmarker\" >C-reactive protein (CRP) as an inflammation marker<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Unterschied_zwischen_Morbus_Crohn_und_Colitis_ulcerosa\" >Difference between Crohn's disease and ulcerative colitis<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Fakales_Calprotectin_als_Entzundungsmarker\" >Fecal calprotectin as an inflammation marker<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Calprotectin_CRP_%E2%80%93_Bedeutung_fur_die_Therapie\" >Calprotectin &amp; CRP - significance for therapy<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#S3_Guidelines\" >S3 Guidelines<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Fazit\" >Conclusion<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/cms.core-way.de\/en\/entzuendungsmarker-bei-ced\/#Quellen\" >Sources:<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"Warum_kann_durch_die_genannten_Entzundungsmarker_eine_CED_nicht_eindeutig_nachgewiesen_werden\"><\/span>Why can't IBD be clearly detected by the inflammation markers mentioned?<span class=\"ez-toc-section-end\"><\/span><\/h2><\/div>\n\n\n\n<p>The reason for this is that both the calprotectin value and the CRP value are not only elevated in the case of IBD, but also as a result of <strong>other diseases<\/strong> can be elevated. For example, the calprotectin value can also be elevated in coeliac disease, infectious gastroenteritis or colorectal carcinomas and the CRP value in various viral or bacterial diseases. However, if IBD has been reliably diagnosed, the values for <strong>Assessment of inflammatory activity<\/strong> and thus to the <strong>Therapy monitoring<\/strong> be helpful. Especially as these <strong>non-invasive<\/strong>, <strong>fast<\/strong> and comparatively <strong>simple<\/strong> can be measured, they are well suited for monitoring the progress of IBD - even if a colonoscopy is not possible.<\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-9f92f8be\"><h3 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"C-reaktives_Protein_CRP_als_Entzundungsmarker\"><\/span>C-reactive protein (CRP) as an inflammation marker<span class=\"ez-toc-section-end\"><\/span><\/h3><\/div>\n\n\n\n<p>C-reactive protein (CRP) is a plasma protein that is involved in both acute and chronic inflammatory processes in the body. <strong>Liver<\/strong> formed and into <strong>Blood<\/strong> is released. As an increase in the CRP value is not only indicative of IBD, but can be elevated in any form of inflammation in the body, it cannot be used as a clear sign of a change in IBD. Other inflammations in the body can be caused by&nbsp; <strong>viral or bacterial disease<\/strong> can also be the case with injuries. The CRP value basically indicates inflammation throughout the body. Nevertheless, testing the C-reactive protein (CRP) in the blood can help to assess inflammatory activity.&nbsp;<\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-4b77e49c\"><h2 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"Unterschied_zwischen_Morbus_Crohn_und_Colitis_ulcerosa\"><\/span>Difference between Crohn's disease and ulcerative colitis<span class=\"ez-toc-section-end\"><\/span><\/h2><\/div>\n\n\n\n<p>While the CRP value rises in most patients with active Crohn's disease, in some cases there is little or no increase in active ulcerative colitis, and the reason for this correlation between the CRP value in Crohn's disease and the CRP value in ulcerative colitis has not yet been established. The CRP value cannot increase in Crohn's disease patients because it depends on the <strong>individual production capacity <\/strong>in the liver. This means that the value can vary from person to person, as a lot or little CRP is produced depending on the individual's production capacity.  For these very reasons, it is particularly interesting to monitor CRP levels to assess the course of the disease. In summary, however, the value allows<strong> no reliable conclusion <\/strong>on the disease activity, but can be helpful in individual cases.<\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-b32b2ecf\"><h3 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"Fakales_Calprotectin_als_Entzundungsmarker\"><\/span>Fecal calprotectin as an inflammation marker<span class=\"ez-toc-section-end\"><\/span><\/h3><\/div>\n\n\n\n<p>Calprotectin is a protein that is found, among other things, in <strong>Stool samples<\/strong> is found. The concentration of calprotectin in the stool represents the migration of neutrophils through the <strong>inflamed intestinal wall<\/strong> into the intestinal cavity. As the sample material is specific to the gastrointestinal tract, elevated calprotectin values can provide information about inflammation specifically in the intestine. In addition, an elevated value before the onset of symptoms can indicate a <strong>potentially imminent surge<\/strong> point out. As calprotectin also <strong>over several days<\/strong> is detectable in the stool, this parameter is suitable for clinical routine and thus represents a <strong>Non-invasive method for therapy monitoring<\/strong> represent.&nbsp;<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Calprotectin_CRP_%E2%80%93_Bedeutung_fur_die_Therapie\"><\/span>Calprotectin &amp; CRP - significance for therapy<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Marker<\/strong><\/td><td><strong>Standard value<\/strong><\/td><td><strong>Mildly increased<\/strong><\/td><td><strong>Indication of active inflammation<\/strong><\/td><\/tr><tr><td><strong>CRP<\/strong> (C-reactive protein)<\/td><td>&lt; 5 mg\/L<\/td><td>5-10 mg\/L<\/td><td>&gt; 10 mg\/L<\/td><\/tr><tr><td><strong>Calprotectin (stool)<\/strong><\/td><td>&lt; 50 \u00b5g\/g<\/td><td>50-150 \u00b5g\/g<\/td><td>&gt; 150-250 \u00b5g\/g (borderline)&gt; 250 \u00b5g\/g (high)<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>According to the current S3 guideline, biochemical markers such as CRP and\/or faecal calprotectin should be used early - within the first three months of starting or switching therapy - to assess the response to therapy. They complement clinical parameters and imaging procedures such as intestinal sonography.<\/p>\n\n\n\n<p>According to a meta-analysis, a fecal calprotectin value below 50 \u00b5g\/g is a strong indication against small bowel involvement in Crohn's disease. Calprotectin provides valuable information, particularly in the follow-up diagnosis of symptom-free patients:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Even without clinical symptoms, an elevated calprotectin level can indicate impending disease activity.<br><\/li>\n\n\n\n<li>Studies show: The risk of relapse with an elevated value is 53-83 % within 23 months.<br><\/li>\n\n\n\n<li>If calprotectin is within the normal range, the probability of a sustained remission is 67-94 %.<br><\/li>\n<\/ul>\n\n\n\n<p>A rising calprotectin value should therefore be taken seriously even in clinical remission and can lead to closer monitoring, an early endoscopic check-up or an adjustment of therapy.<\/p>\n\n\n\n<p><\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-5bf83b75\"><h2 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"S3_Guidelines\"><\/span>S3 Guidelines<span class=\"ez-toc-section-end\"><\/span><\/h2><\/div>\n\n\n\n<p>After starting or changing therapy, biochemical markers such as CRP and\/or fecal calprotectin as well as intestinal sonography should be used to evaluate the response to therapy within the first three months in addition to clinical parameters.<\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-78b03b4a\"><h2 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"Fazit\"><\/span>Conclusion<span class=\"ez-toc-section-end\"><\/span><\/h2><\/div>\n\n\n\n<p>In summary, laboratory markers such as C-reactive protein (CRP) and fecal calprotectin can be used from diagnosis to treatment. <strong>Disease monitoring <\/strong>can help the <strong>Inflammatory activity <\/strong>to be assessed. Nevertheless, these laboratory markers cannot reliably rule out or prove the presence of IBD. Nevertheless, in combination with the occurrence of symptoms and other vital parameters such as the <a href=\"https:\/\/cms.core-way.de\/en\/heart-rate-variability-hrv-what-it-means-why-it-matters\/\">Heart rate variability<\/a> (HRV) can serve as a guide. It is important to always compare the values with the <strong>previous course<\/strong>the <strong>current symptoms<\/strong> and the <strong>individual state of mind<\/strong> with your gastroenterologist or gastroenterologist.<\/p>\n\n\n\n<div class=\"wp-block-uagb-advanced-heading uagb-block-a893c6ee\"><h2 class=\"uagb-heading-text\"><span class=\"ez-toc-section\" id=\"Quellen\"><\/span>Sources:<span class=\"ez-toc-section-end\"><\/span><\/h2><\/div>\n\n\n\n<p>ARUP Consult. Inflammatory Markers. Available at: <a href=\"https:\/\/arupconsult.com\/content\/inflammatory-markers\">https:\/\/arupconsult.com\/content\/inflammatory-markers<\/a>.<\/p>\n\n\n\n<p>Cleveland Clinic. Inflammation. Available at: https:\/\/my.clevelandclinic.org\/health\/symptoms\/21660-inflammation.<\/p>\n\n\n\n<p>Fengming, Y &amp; Jianbing. Biomarkers of Inflammatory Bowel Disease. <em>Disease Markers <\/em>1, 1-11 (2014). <a href=\"http:\/\/dx.doi.org\/10.1155\/2014\/710915\">http:\/\/dx.doi.org\/10.1155\/2014\/710915<\/a><\/p>\n\n\n\n<p>Hauer, A.C. Laboratory diagnostics in chronic inflammatory bowel disease. <em>Monatsschr Kinderheilkd<\/em> 168, 314-322 (2020). <a href=\"https:\/\/doi.org\/10.1007\/s00112-020-00853-8\">https:\/\/doi.org\/10.1007\/s00112-020-00853-8<\/a><\/p>\n\n\n\n<p>Heida A, Park KT, van Rheenen PF. Clinical Utility of Fecal Calprotectin Monitoring in Asymptomatic Patients with Inflammatory Bowel Disease: A Systematic Review and Practical Guide. Inflamm Bowel Dis 2017; 23: 894-902<br><\/p>\n\n\n\n<p>Helwig, U. (2023). Laboratory diagnostics. In: Sturm, A. (eds) Care in chronic inflammatory bowel disease. Springer, Berlin, Heidelberg. <a href=\"https:\/\/doi.org\/10.1007\/978-3-662-64938-1_7\">https:\/\/doi.org\/10.1007\/978-3-662-64938-1_7<\/a><\/p>\n\n\n\n<p>Klag, T., Stange, E. &amp; Wehkamp, J. Laboratory diagnostics in chronic inflammatory bowel disease, including blood and stool diagnostics. <em>Gastroenterologist<\/em> 9, 117-126 (2014). <a href=\"https:\/\/doi.org\/10.1007\/s11377-013-0838-3\">https:\/\/doi.org\/10.1007\/s11377-013-0838-3<\/a><\/p>\n\n\n\n<p>Kopylov U, Yung DE, Engel Tet al. Fecal calprotectin for the prediction of small-bowel Crohn's disease by capsule endoscopy: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2016; 28: 1137-1144<\/p>\n\n\n\n<p>Koutra, E., Lusm\u00f6ller, E., &amp; Stadler, R. (2021). Calprotectin - a key to the diagnosis of chronic inflammatory bowel disease in inflammatory dermatoses? The Dermatologist, 73, 303-307. <a href=\"https:\/\/doi.org\/10.1007\/s00105-021-04821-5\">https:\/\/doi.org\/10.1007\/s00105-021-04821-5<\/a>.<\/p>\n\n\n\n<p>MedlinePlus. Calprotectin Stool Test. Available at: <a href=\"https:\/\/medlineplus.gov\/lab-tests\/calprotectin-stool-test\/#:~:text=Depending%20on%20your%20symptoms%20and,(WBC)%20in%20stool%20test\">https:\/\/medlineplus.gov\/lab-tests\/calprotectin-stool-test\/#:~:text=Depending%20on%20your%20symptoms%20and,(WBC)%20in%20stool%20test<\/a>.<\/p>\n\n\n\n<p>National Institute for Health and Care Research. Inflammatory Markers Explained. Available at: <a href=\"https:\/\/arc-w.nihr.ac.uk\/news\/inflammatory-markers-explained\/\">https:\/\/arc-w.nihr.ac.uk\/news\/inflammatory-markers-explained\/<\/a>.<\/p>\n\n\n\n<p>Oremek, G., Holzgreve, F., Wanke, E. <em>et al.<\/em> C-reactive protein (CRP) - a diagnostic marker of inflammation using the example of selected indications. <em>Zbl Arbeitsmed<\/em> 74, 140-144 (2024). <a href=\"https:\/\/doi.org\/10.1007\/s40664-023-00523-y\">https:\/\/doi.org\/10.1007\/s40664-023-00523-y<\/a><\/p>\n\n\n\n<p>Prager, M., B\u00fcning, C. Clinic, CRP, calprotectin, MRI or endoscopy? <em>coloproctology<\/em> 36, 250-258 (2014). <a href=\"https:\/\/doi.org\/10.1007\/s00053-014-0464-7\">https:\/\/doi.org\/10.1007\/s00053-014-0464-7<\/a>.<\/p>\n\n\n\n<p>Stiefelhagen, P. The family doctor should not only think of IBD in the case of diarrhea. <em>MMW - Advances in medicine<\/em> 163, 18 (2021). <a href=\"https:\/\/doi.org\/10.1007\/s15006-021-0205-0\">https:\/\/doi.org\/10.1007\/s15006-021-0205-0<\/a><\/p>\n\n\n\n<p>Vinding, K., Elsberg, H., Thorkilgaard, T., B\u00e9lard, E., Pedersen, N., Elkjaer, M., Marker, D., Carlsen, K., Burisch, J., &amp; Munkholm, P. (2016). Fecal Calprotectin Measured By Patients at Home Using Smartphones-A New Clinical Tool in Monitoring Patients with Inflammatory Bowel Disease. Inflammatory Bowel Diseases, 22, 336-344. <a href=\"https:\/\/doi.org\/10.1097\/MIB.0000000000000619\">https:\/\/doi.org\/10.1097\/MIB.0000000000000619<\/a>.<\/p>\n\n\n\n<p>Yamaguchi, S., Takeuchi, Y., Arai, K., Fukuda, K., Kuroki, Y., Asonuma, K., Takahashi, H., Saruta, M., &amp; Yoshida, H. (2016). Fecal calprotectin is a clinically relevant biomarker of mucosal healing in patients with quiescent ulcerative colitis. Journal of Gastroenterology and Hepatology, 31, 93-98. <a href=\"https:\/\/doi.org\/10.1111\/jgh.13061\">https:\/\/doi.org\/10.1111\/jgh.13061<\/a>.<\/p>","protected":false},"excerpt":{"rendered":"<p>In chronic inflammatory bowel disease, inflammatory markers such as C-reactive protein (CRP) and fecal calprotectin play an important role from diagnosis to [...]<\/p>","protected":false},"author":8,"featured_media":3859,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","inline_featured_image":false,"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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