ALGORITHM FOR DIFFERENTIAL DIAGNOSIS OF THE MOST PREVALENT ORGANIC AND FUNCTIONAL BOWEL PATHOLOGY

Abstract

Purpose of research: to develop an algorithm of differential diagnosis of the most prevalent organic and functional bowel disease on the basis of two «detecting» markers, i.e. fecal lactoferrin and fecal occult blood. Subject: The study included 48 patients with colorectal cancer, 52 patients with ulcerative colitis, 46 patients with irritable bowel syndrome and 25 healthy volunteers. Results: according to the previously published results of our study immunochemical test for occult blood in feces and fecal lactoferrin the most effective «detecting» markers of organic intestinal disease. The sensitivity of immunochemical fecal occult blood test is 84,44 % (95 % CI: 75,30-91,20), specificity - 100 %, fecal lactoferrin - 85,56 % (95 % CI: 76,60-92,10) and 84,78 % (95 % CI: 71,10-93,60), respectively. Combined determination of fecal lactoferrin and fecal occult blood can increase the sensitivity of each marker separately (97,78 %, 95 % CI: 92,20-99,70, p = 0,003 and p = 0,003, respectively). Conclusion: the application of fecal occult blood test and fecal lactoferrin may be assumed as the basis for the algorithm of differential diagnosis of organic and functional bowel disease, because the use of fecal occult blood test and/or fecal lactoferrin makes it possible to reveal signs of organic bowel disease and to establish the indications for its further in-depth examination.