Summary: A new study found that by combining clinical history with multiple home stool tests, particularly fecal calprotectin (FCP) tests, the use of serial FCP tests could strongly predict possible IBD, Crohn’s Disease, and Ulcerative Colitis. 


  • The new protocol for diagnosing IBD aims to provide a more accurate diagnosis and reduce the strain on current testing methods, particularly colonoscopies.
  • Incorporating serial Fecal calprotectin (FCP) testing into the diagnostic process can help identify patients who urgently need a referral to secondary care, speeding up the diagnostic process.
  • The study suggests that combining home FCP testing with symptom questionnaires could enable patients to self-refer to secondary care services, reducing the burden on primary care and facilitating quicker access to specialized care. 

Patients with suspected inflammatory bowel disease (IBD) could benefit from better testing protocols that would reduce the need and lengthy wait for potentially unnecessary colonoscopies, a new study has found.

New Protocol for IBD Diagnosis

In a paper published in Frontline Gastroenterology, researchers from the Birmingham NIHR Biomedical Research Centre (BRC) at the University of Birmingham tested a new protocol to improve IBD diagnosis by combining clinical history with multiple home stool tests.

Incorporating Fecal Calprotectin Testing

In the two-year study involving 767 participants, patients were triaged and had repeated fecal calprotectin (FCP) tests and the research team found that the use of serial FCP tests were able to strongly predict possible IBD as well as Crohn’s Disease and Ulcerative Colitis.

The team observed that a second FCP test was a strong indicator of a potential need for further investigation including colonoscopy; although the researchers observed that only 20% of patients had two samples submitted before referral to secondary care.

Speeding up Inflammatory Bowel Disease Testing

“Patients who experience symptoms associated with inflammatory bowel diseases often have a long wait until getting a diagnosis, and current testing is under immense strain,” Says Peter Rimmer, PhD, from the Birmingham NIHR Biomedical Research Centre at the University of  Birmingham and corresponding author of the study. “Using a comprehensive 13-point symptom checker and multiple FCP tests, we have been able to identify much more accurately patients who had IBD and other diseases. The rollout of this protocol could reduce the time taken to get a diagnosis and start treatment for IBDs as much more of the screening and testing can be done through primary care. The sensitivity of multiple FCP tests can be used to flag those patients who urgently need referral into secondary care.”

Further reading: Fecal Testing: Measuring Quality Over Quantity

“In its simplest form, this study may help improve referral triage for IBD patients,” says Rachel Cooney, PhD, consultant gastroenterologist at University Hospitals Birmingham NHS Foundation Trust, researcher at the NIHR Birmingham BRC and co-author of the study. “But as we plan new care pathways, it could open up new exciting possibilities:  with the growing availability of home FCP testing, these tests’ results combined with simple symptom questionnaires could feed into algorithms that allow patients to self-refer to secondary care services, reducing strain on primary care. This is something we’re going to explore in a large follow-up study we’re currently initiating.”