title: Effect of oral diclofenac intake on faecal calprotectin.
abstract: BACKGROUND
  NSAIDs are a known source of increased faecal calprotectin (FC) levels. Currently, there is a lack of knowledge about how long it takes for an increased FC level to return to normal after NSAID intake.
  
  
  OBJECTIVE
  The aim was to investigate how oral diclofenac intake affects FC levels and assess how long it takes for an increased FC level to return to normal after oral diclofenac intake.
  
  
  METHODS
  Thirty healthy volunteers received diclofenac 50 mg three times daily for 14 days. Participants provided a stool sample on Days 0, 2, 4, 7, 14 during intake and Days 17, 21, 28 after discontinuation. FC levels were then followed at 7-day intervals until normalization.
  
  
  RESULTS
  During diclofenac intake, eight participants (27%) had FC levels exceeding the upper limit of normal (median, 76 μg/g; range, 60-958 μg/g), corresponding to 8.3% of measurements. FC was not constantly increased and became normal in most participants during diclofenac intake. FC levels were on average significantly higher during intake (M = 9.5, interquartile range (IQR) = 13.4) than on baseline (M = 7.5, IQR = 0.0), p = 0.003. After discontinuation, two participants had increased FC on Days 17 and 21, respectively. No significant differences in FC levels were found between baseline and measurements after discontinuation. Two weeks after discontinuation, all participants had normal FC levels.
  
  
  CONCLUSIONS
  Short-term oral diclofenac intake is associated with increased FC levels. However, the likelihood of an increased test result is low. Our results suggest that 2 weeks of diclofenac withdrawal is sufficient to get an uninfluenced FC test result.
authors.affiliation: a 1 Primary Health Care and Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Zlatica
authors.initials: Z
authors.lastname: Rendek
authors.affiliation: b 2 Department of Medical and Health Sciences, Division of Community Medicine, Primary Care, Linköping University , Linköping, Sweden.|c 3 Research and Development Unit for Local Health Care, County Council of Östergötland , Linköping, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Falk
authors.affiliation: d 4 Department of Medical and Health Sciences, Division of Drug Research/Clinical Pharmacology, Linköping University , Linköping, Sweden.|e 5 The National Board of Forensic Medicine , Linköping, Sweden.
authors.forename: Ewa
authors.initials: E
authors.lastname: Grodzinsky
authors.affiliation: f 6 Department of Computer and Information Science, Linköping university , Linköping, Sweden.
authors.forename: Karl
authors.initials: K
authors.lastname: Wahlin
authors.affiliation: g 7 Department of Gastroenterology and Department of Medical and Health Sciences, Linköping University , Linköping, Sweden.
authors.forename: Stergios
authors.initials: S
authors.lastname: Kechagias
authors.affiliation: h 8 Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Rikard
authors.initials: R
authors.lastname: Svernlöv
authors.affiliation: h 8 Department of Gastroenterology and Department of Clinical and Experimental Medicine, Linköping University , Linköping, Sweden.
authors.forename: Henrik
authors.initials: H
authors.lastname: Hjortswang
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D004008:Diclofenac / Q000008:administration & dosage*; D005243:Feces / Q000737:chemistry*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D013548:Sweden; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D039841:Leukocyte L1 Antigen Complex; D004008:Diclofenac
keywords: NSAIDs; calprotectin; diclofenac; intestinal inflammation; non-steroidal anti-inflammatory agents; proton pump inhibitors