A fecal lactoferrin test can detect intestinal inflammation. High lactoferrin levels in stool suggest that inflammation is present. This may indicate a bacterial infection or inflammatory bowel disease (IBD).
Lactoferrin is a protein that protects the body against viruses and bacteria. It is present in mammals’ milk, including that of humans. It is also in saliva, tears, and mucus.
High lactoferrin levels in stool samples may indicate inflammation in the gastrointestinal (GI) tract. A fecal lactoferrin test can help doctors diagnose a condition before symptoms arise.
This article explains the significance of lactoferrin in stool, how doctors test for it, the meaning of different fecal lactoferrin levels, and the benefits of fecal lactoferrin testing over other tests.
Fecal lactoferrin testing can detect inflammation in the intestines, which can help doctors provide a diagnosis for people with symptoms such as abdominal pain and diarrhea.
There are various possible causes of abdominal-related symptoms, including:
- inflammatory bowel disease (IBD)
- infections
- radiation colitis
- ischemic colitis
- cancer
The test
IBD can affect people of any age, but most diagnoses occur between the ages of
If the stool has a high lactoferrin level, an individual may have inflammation in their GI tract. However, the test cannot specify the cause, so a person may need to undergo an endoscopy exam as a follow-up.
A negative lactoferrin does not mean that a person definitely has IBD or another bowel condition. Doctors tend to use it as a screening test. It does not also mean there is no inflammation, just that it is not present in that sample or it is too small to be detected.
Lactoferrin levels can also be moderate, meaning that some inflammation may be present. If a doctor performs another test that shows an increase in lactoferrin levels, the condition may have worsened.
Fecal lactoferrin testing may be a better option than other tests for some people.
Testing during pregnancy
Endoscopies, CT scans, and MRI exams can help healthcare professionals
However, a 2020 study explains that an endoscopy procedure may not be safe during pregnancy, as it might increase the risk of preterm birth or low gestational weight. A CT scan can also increase the chance of congenital anomalies.
Fecal lactoferrin testing is not expensive, and it can help monitor IBD during pregnancy.
Key terms explained: Endoscopy
An endoscopy is a medical procedure that uses a thin, flexible tube with a camera on the end — called an endoscopy — to view inside the body.
Testing in children
A 2025 study describes lactoferrin as a highly sensitive and specific fecal biomarker that offers a noninvasive way to help doctors distinguish IBS and IBD.
Since it is noninvasive, this test may be a preferable diagnostic tool for children or others who do not wish to have an endoscopy.
Testing in the case of a possible flare-up
People with recurring symptoms may have IBD flare-ups. A fecal biomarker test cannot determine whether someone has IBD. However, if the test is negative, it indicates no sign of inflammation or infection.
People with positive results may require further evaluation. While tests are ongoing, the medical team may not prescribe anti-inflammatory medications.
The authors of a 2020 study suggest that fecal biomarkers can help doctors monitor people with IBD and predict disease progression. In people with IBD, stool testing can take place at any stage of the disease.
A 2025 study compared fecal lactoferrin in people with IBS and IBD in Bangladesh. They found that lactoferrin levels were significantly higher in people with IBD, and suggest this test may help doctors differentiate between the two conditions.
A 2024 study also suggests that fecal lactoferrin and calprotectin tests may be helpful when detecting colorectal tumors, instead of only using tests to detect hemoglobin levels.
Doctors may not recommend lactoferrin testing when a person is breastfeeding, as human breast milk contains about 8 to 10 milligrams of lactoferrin.
Doctors may suggest a calprotectin test as an alternative to a lactoferrin test.
Other tests that a person undergoes may depend on their symptoms and the suspected diagnosis. For example, the Crohn’s & Colitis Foundation lists the following tests that may help doctors diagnose IBD:
- Blood tests: These can help detect anemia, which occurs when there are not enough red blood cells carrying oxygen to bodily tissues. Blood tests can also determine whether a person requires further testing.
- Colonoscopy: During a colonoscopy, a doctor uses an endoscope to view the colon. They may also take tissue samples and send them to a laboratory for analysis.
- Sigmoidoscopy: A doctor will use an endoscopy to examine the left side of the colon. Sigmoidoscopy, which usually takes place without sedation, can indicate how the body is responding to treatment.
- Pouchoscopy: A pouchoscopy is a procedure that allows healthcare professionals to examine the lining of the small bowel. It may take about 10 minutes and can help check for ulcers, inflammation, and polyps.
- CT scan: This imaging test takes several X-rays of the internal organs from different angles. CT scans
can help doctors diagnose and monitor bowel issues such as IBD.
A lactoferrin stool test can help determine whether a person has intestinal inflammation, which can help diagnose IBD, infections, and other conditions.
A lactoferrin stool test may be a good option for children, as they may feel uncomfortable undergoing a colonoscopy, which requires the insertion of a tube into the colon.
It may be useful during pregnancy, as some imaging exams, such as CT scans, may increase the risk of pregnancy complications or congenital anomalies.
Doctors may also use other tests to check for IBD, including a pouchoscopy, a blood test, or a sigmoidoscopy.