Alpha-1 antitrypsin (feces)

Alpha-1 antitrypsin (feces) too high

A raised value means that protein from the blood is being lost through the gut wall. This may fit a chronic inflammation of the bowel such as Crohn's disease, celiac disease, an intestinal infection or a problem with the drainage of lymph fluid from the gut. Symptoms that fit this are long-lasting diarrhea, weight loss and fluid retention (swollen ankles) due to a low protein level in the blood. Blood in the stool, including menstrual blood, raises the value without there being any protein loss.

Alpha-1 antitrypsin (feces) too low

A low or undetectable value is the usual result and means that there is no measurable protein loss through the gut. A low value in the stool says nothing about an inherited deficiency of alpha-1 antitrypsin; that is measured in the blood.

Useful for

In people without symptoms, an abnormal result says little, because the meaning has not been established and a passing infection or a painkiller can raise the value. With long-lasting diarrhea or abdominal symptoms, the GP uses calprotectin in the stool to rule out a chronic inflammation of the bowel, and a blood test if celiac disease is suspected. With blood in the stool, unintended weight loss, diarrhea at night or new bowel symptoms after age 50, this test is no substitute for a visit to the GP.

How common is it?

Bowel symptoms are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults in the Netherlands. Chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis are much rarer; the guideline gives no Dutch figure for them. How often an abnormal result for these markers occurs in people without symptoms is not known.

Dutch medical specialists' guideline (FMS) on irritable bowel syndrome (NHG and NVMDL)