| Inflammatory bowel disease – the role of faecal calprotectin |
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Clinical assessment of intestinal inflammation can be problematic. Faecal calprotectin can be useful in differentiating between IBS and IBD, but it is not funded or widely available.
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| Pernicious anaemia |
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There are a number of causes of low vitamin B12 levels with pernicious anaemia being among the most important to identify. Parietal cell and intrinsic factor antibodies have an important role to play when investigating the possibility of pernicious anaemia.
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| Helicobacter pylori |
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The choice of test for initial testing for H. pylori, is determined by prevalence. In areas where the local prevalence is >30%, serology tests are best. In areas of low prevalence, stool antigen testing is the better option.
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| Coeliac disease |
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Tissue transglutaminase antibodies are the most useful preliminary step for testing people with a clinical picture suggestive of coeliac disease.
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| Steatorrhoea |
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In the past, the faecal fat test was sometimes used to aid the diagnosis of steatorrhoea. This practice is no longer recommended. There are other tests available that can provide more valuable information.
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| Lactose intolerance |
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| The role of laboratory tests in diagnosing lactose intolerance in primary care is limited. In most cases the diagnosis can be made on clinical grounds and by a trial of a lactose-free diet. |
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ACKNOWLEDGEMENTS: Thanks to the following for their expert guidance in developing these series of articles:
- Dr John O’Donnell, Clinical Immunologist, Canterbury Health Laboratories, Christchurch
- Dr John Wyeth, Gastroenterologist and Clinical Director of Medicine, Capital & Coast DHB, Wellington
- Dr Alan Fraser, Gastroenterologist and Hepatologist, Mercy Specialist Centre, Auckland
- Dr Edward Theakston, Haematologist, Diagnostic Medlab, Auckland
- Dr Marianne Empson, Clinical Immunologist, Diagnostic Medlab, Auckland
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