{
  "abstract": "Background Differentiating Irritable Bowel Syndrome (IBS) from Inflammatory Bowel Disease (IBD) remains a common clinical challenge and often leads to unnecessary endoscopic procedures and increased healthcare burden. Fecal calprotectin (FC) is a calcium-binding protein released by activated neutrophils, reflects intestinal inflammation and has emerged as a promising non-invasive biomarker. Reported diagnostic thresholds, performance vary across populations, and real-world data from Southeast Asia remain limited. This study aimed to evaluate the diagnostic performance of FC in distinguishing IBS from IBD in routine clinical practice.Methods The researcher conducted a prospective diagnostic study at Bali International Hospital, Indonesia between July 2025 and December 2025. Adult patients presenting with chronic gastrointestinal symptoms suggestive of IBS or IBD were consecutively enrolled. Exclusion criteria included recent infection, antibiotic use, or known colorectal malignancy. All patients underwent FC testing prior to definitive diagnostic evaluation. Final diagnosis was established using standard clinical assessment including endoscopy and histopathology where indicated, serving as the reference standard. Receiver operating characteristic (ROC) curve analysis was performed to evaluate discriminative ability. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated at clinically relevant cutoff levels.Results A total of 42 patients were included, comprising 57.1% IBS and 42.9% IBD, with comparable baseline demographic characteristics between groups. Median FC levels were substantially higher in IBD compared to IBS patients (285 vs 52 µg/g), with minimal overlap observed between groups. ROC analysis demonstrated good discriminative ability with an AUC of 0.84. At a cutoff of 120 µg/g, FC yielded a sensitivity of 81.3% and specificity of 78.3% with corresponding PPV and NPV indicating balanced diagnostic performance. At a lower threshold (<50 µg/g), FC demonstrated a high negative predictive value, effectively excluding IBD in the majority of cases. Higher FC levels (>150 µg/g) were strongly associated with inflammatory pathology.Conclusions Fecal calprotectin demonstrates good diagnostic performance in differentiating IBS from IBD in a real-world Southeast Asian setting. Despite the modest sample size, the consistent separation of FC levels between groups supports clinically meaningful utility. FC may serve as a practical non-invasive tool to guide decision-making and reduce unnecessary endoscopic evaluations.",
  "authors": [
    {
      "affiliations": [
        "General Practitioner, Bali International Hospital, Indonesia"
      ],
      "name": "I-Gusti Ngurah Bagus Rai Mulya Hartawan"
    }
  ],
  "title": "IDDF2026-ABS-0541 Diagnostic performance of fecal calprotectin in differentiating irritable bowel syndrome from inflammatory bowel disease: a prospective real-world study from southeast Asia",
  "uid": "38cef32b-f7bc-5890-83cc-4ece28e4d2f6"
}