What Does a Positive Fecal Lactoferrin Test Mean - Body of Harmony

What Does a Positive Fecal Lactoferrin Test Mean

by: Payam Hakimi
April 2025
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When it comes to investigating digestive symptoms like abdominal pain, diarrhea, or unexplained weight loss, your healthcare provider may order a test called fecal lactoferrin. But what does it mean if the result comes back positive?

Let’s break it down in simple terms.

What Is Fecal Lactoferrin?

Lactoferrin is a protein found in white blood cells, specifically the kind that respond to inflammation (called neutrophils). When there's inflammation in the intestines, those white blood cells can migrate into the gut lining and release lactoferrin—which then shows up in your stool.

So when a test detects fecal lactoferrin, it’s a sign that your body is mounting an inflammatory response inside the gastrointestinal (GI) tract.

What Does a Positive Result Mean?

A positive fecal lactoferrin test means that there's likely active inflammation in the intestines. This is not a diagnosis by itself, but it’s a very useful marker to help differentiate between inflammatory bowel disease (IBD) and non-inflammatory conditions, such as irritable bowel syndrome (IBS).

Conditions Associated with Positive Fecal Lactoferrin:

Inflammatory Bowel Disease (IBD)
- Crohn’s Disease
- Ulcerative Colitis
Bacterial Infections
- Certain bacterial pathogens like C. difficile, Salmonella, or Shigella can cause inflammation and trigger a positive result.
Ischemic Colitis
- A condition where blood flow to part of the colon is reduced, causing inflammation and damage.
Colorectal Cancer (less commonly)
- May also cause inflammation and bleeding that leads to elevated lactoferrin.

What It Doesn’t Indicate:

It does not tell you the specific cause of inflammation.
It does not rule out all GI problems—some conditions may not elevate lactoferrin.

For example:

Irritable Bowel Syndrome (IBS) typically does not cause a positive lactoferrin test.
Functional GI issues may still cause significant discomfort without showing inflammation.

What’s the Next Step?

If your fecal lactoferrin is positive, your provider may order:

Further stool tests (e.g., cultures, calprotectin, or pathogen panels)
Blood work
Imaging studies
Endoscopy or colonoscopy to visualize the GI tract and take biopsies.

The goal is to identify the root cause of inflammation and create an appropriate treatment plan.

If you've had a positive result, it’s important to follow up with your healthcare provider to dig deeper and take the right next steps.

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