Lactoferrin (feces)

Lactoferrin (feces) too high

A raised lactoferrin points to inflammatory cells in the gut. This may fit chronic inflammatory bowel disease such as Crohn's disease or ulcerative colitis, especially with long-lasting diarrhea, blood or mucus in the stool and weight loss. A raised value also occurs with a bacterial gut infection and with use of anti-inflammatory painkillers (NSAIDs). In breastfed babies the value is higher, because breast milk contains a lot of lactoferrin. Rarely: a bowel polyp or bowel cancer.

Lactoferrin (feces) too low

A low value makes active inflammation of the bowel wall less likely. With recurring abdominal pain and changing bowel habits, this more likely fits irritable bowel syndrome. For ruling out chronic inflammatory bowel disease, the cut-off values of calprotectin are better established than those of lactoferrin.

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)