Comprehensive Gastroenterology Tests and Diagnosis

At PACE Hospitals, we offer a wide range of advanced diagnostic tests to accurately assess and diagnose gastrointestinal conditions. From non-invasive imaging to specialized procedures, our state-of-the-art technology ensures precise results. Trust our experienced team of gastroenterologists to provide quick, reliable diagnoses and personalized treatment plans for your digestive health.

Laboratory Tests

These assess function, inflammation, or infection.

Complete Blood Count (CBC)

CBC helps to detect gastrointestinal diseases by identifying abnormalities in blood components. For example, low hemoglobin or red blood cells may indicate GI bleeding, high white blood cells may indicate infection or inflammation, and platelet abnormalities may indicate liver or digestive problems. While CBC cannot pinpoint a specific GI disease, it provides important clues that guide further tests and diagnosis.

Liver Function Tests (LFTs)

LFTs are a set of blood tests used to assess the liver's health and functionality. These tests measure various enzymes and proteins that are released into the blood when the liver is inflamed or damaged:

• Alanine Aminotransferase (ALT): Elevated ALT levels typically indicate liver cell damage and are commonly associated with liver diseases such as hepatitis or fatty liver disease.
• Aspartate Aminotransferase (AST): Elevated levels can signal liver damage, particularly when the ratio of AST to ALT is high, suggesting alcoholic liver disease or cirrhosis.
• Alkaline Phosphatase (ALP): Increased ALP levels often point to bile duct obstruction or slowed bile flow (called cholestasis), and can be associated with conditions such as gallstones or liver tumors.
• Bilirubin: Bilirubin is a waste product of red blood cell breakdown that is processed by the liver. Elevated bilirubin levels may indicate liver failure or bile duct blockages, resulting in jaundice.

Pancreatic Enzymes

The pancreas produces enzymes called amylase and lipase that aid digestion. They are measured to diagnose pancreatic disorders, especially pancreatitis:

• Amylase: Elevated levels of amylase in the blood can indicate acute pancreatitis or other pancreatic issues, such as blockages or inflammation.
• Lipase: Lipase levels are particularly elevated in cases of acute pancreatitis and are considered a more specific marker for pancreatic inflammation than amylase.

Stool Tests 

Stool tests help in diagnosing a variety of gastrointestinal conditions, particularly those related to the intestines:

• Occult Blood: This test detects hidden (invisible) blood in the stool, which can be a sign of conditions like colorectal cancer, ulcers, inflammatory bowel disease (IBD), or gastrointestinal bleeding from other sources.
• Pathogens: Stool cultures are used to identify bacterial, viral, or parasitic infections, such as Salmonella, E. coli, or Giardia. Identifying the pathogen helps guide appropriate antibiotic or antiparasitic treatment.
• Fat (Steatorrhea): This test measures the presence of undigested fat in the stool, which can indicate malabsorption disorders like celiac disease, chronic pancreatitis, or cystic fibrosis. Excess fat in the stool results in greasy, foul-smelling stools.
• Calprotectin: This is elevated in cases of intestinal inflammation. It is particularly useful as a marker for inflammatory bowel disease such as Crohn’s disease and ulcerative colitis, helping differentiate IBD from other gastrointestinal conditions like irritable bowel syndrome.

Celiac Serology 

Celiac serology tests are blood tests used to help diagnose celiac disease. The two most common markers tested for are:

• Anti-tTG (anti-tissue transglutaminase) antibodies: Its high levels indicate an immune response to gluten, suggesting that a person may have celiac disease. 
• EMA (Endomysial Antibodies): It is often used as a confirmatory test when anti-tTG antibodies are positive, as it has a strong correlation with celiac disease, especially in patients with high levels of tTG antibodies.

Helicobacter pylori Testing 

Helicobacter pylori is a bacterium that infects the stomach lining and is a major cause of gastritis, peptic ulcers, and even stomach cancer. Several methods are used to test for the presence of H. pylori:

• Urea Breath Test: The patient ingests a special substance containing urea, and if H. pylori is present in the stomach, the bacterium breaks down the urea into ammonia and carbon dioxide, which is then detected in the breath. This test is used to diagnose an active infection or confirm eradication after treatment.
• Stool Antigen Test: This test detects H. pylori antigens in the stool. It diagnoses active infection and is often used to check for reinfection after treatment. 
• Serology: Blood tests that detect antibodies to H. pylori can indicate past or current infection. However, serology is less commonly used for diagnosing active infection, but it is more useful for detecting past exposure.

Imaging Tests

Used to visualize structures, detect obstructions, inflammation, or masses.

Abdominal Ultrasound

This is a non-invasive imaging technique that creates images of the organs and structures inside the abdomen. It is utilised to evaluate the liver, gallbladder, kidneys, pancreas, and spleen. Ultrasound can help detect conditions such as gallstones, liver disease, kidney stones, abdominal masses, or fluid collections like ascites. 

Computed Tomography Scan/ CT Enterography 

• CT scan creates detailed cross-sectional images of the abdomen. It is used to diagnose a wide range of conditions such as abdominal tumors, inflammatory bowel disease (IBD), infections, and diverticulitis. The use of contrast agents enhances the visibility of the intestines, blood vessels, and organs.
• CT Enterography is a specialised form of CT scanning that focuses on imaging the small intestine. It is useful in diagnosing conditions like Crohn's disease, small bowel obstructions, and other small intestinal disorders. This provides images that can detect inflammation, strictures, and abnormalities that abdominal CT scans may not reveal.

Magnetic Resonance Imaging / Magnetic Resonance Cholangiopancreatography (MRCP)

• MRI is a non-invasive imaging technique that creates detailed images of soft tissues in the abdomen. MRI is particularly helpful for assessing liver diseases, pancreatic disorders, and identifying masses or tumors in the abdominal cavity. 
• MRCP is a specialised MRI technique designed to visualize the bile ducts, pancreatic ducts, and gallbladder. It is used to diagnose and evaluate conditions such as bile duct obstructions, gallstones, pancreatitis, or bile duct cancer. 

Barium Swallow / Upper GI Series

Barium swallow is an X-ray procedure used to examine the upper gastrointestinal tract, including the esophagus, stomach, and the first part of the small intestine (duodenum). This allows the physician to identify abnormalities such as strictures, ulcers, tumors, or structural issues like a hiatal hernia or gastroesophageal reflux disease (GERD). This test is particularly useful in diagnosing swallowing difficulties, reflux disease, and certain types of cancer.

Barium Enema / Lower GI Series

Barium enema is a diagnostic X-ray procedure used to evaluate the colon (large intestine) and rectum. This helps to detect conditions such as polyps, diverticulosis, tumors, colitis, and other inflammatory bowel diseases. The test is useful for diagnosing conditions related to bowel movements, unexplained abdominal pain, or changes in bowel habits, and can be an essential tool in screening for colorectal cancer.

Endoscopic Diagnostic Procedures

Allows direct visualization of the GI tract.

Upper GI Endoscopy (EGD)

EGD is a procedure where a flexible tube with a camera (endoscope) is inserted through the mouth to visualise the esophagus, stomach, and the upper part of the small intestine (duodenum). It allows doctors to diagnose and sometimes treat conditions such as gastroesophageal reflux disease (GERD), ulcers, bleeding, tumors, and strictures. EGD is particularly useful for investigating symptoms like persistent heartburn, difficulty swallowing, abdominal pain, nausea, or vomiting. 

Colonoscopy

Colonoscopy is a procedure where a long, flexible tube with a camera is inserted via the rectum to examine the entire colon (large intestine) and rectum. This test is primarily used for the screening and diagnosis of colorectal cancer, polyps, diverticulosis, and IBD. It is also used to investigate symptoms such as unexplained abdominal pain, rectal bleeding, or changes in bowel habits.

Flexible Sigmoidoscopy

This test is similar to a colonoscopy but focuses only on the lower part of the colon and rectum. It is utilised to interpret conditions such as hemorrhoids, colorectal cancer, diverticulosis, and inflammatory bowel diseases in the lower colon. It is a less invasive option and is often used as a screening tool for colorectal cancer or to evaluate specific symptoms such as rectal bleeding or changes in bowel habits.

Capsule Endoscopy

This technique is primarily used to examine parts of the small intestine that are difficult to reach with traditional endoscopy, such as the jejunum and ileum. It is useful for diagnosing obscure gastrointestinal bleeding, unexplained abdominal pain, and conditions that affect the small bowel.

Double Balloon Enteroscopy

This is an advanced endoscopic technique used to examine the small intestine, which is often difficult to reach with traditional endoscopy or capsule endoscopy. This allows for a deeper view of the small intestine and is used for diagnosing and treating conditions such as Crohn’s disease, small bowel tumors, strictures, and gastrointestinal bleeding. 

Endoscopic Ultrasound (EUS)

EUS is a procedure that combines endoscopy and ultrasound to obtain detailed images of the gastrointestinal tract (GIT) and surrounding structures, which also include the pancreas, liver, and lymph nodes. An endoscope with a small ultrasound probe at its tip is inserted into the digestive tract, and sound waves are used to create detailed images of both the internal and external surfaces of organs. It is useful for assessing tumors, cysts, or other abnormalities in the pancreas, bile ducts, and gastrointestinal system. 

Motility and Functional Tests

Evaluate movement or pressure abnormalities in the GI tract.

Esophageal Manometry

This is used to measure the pressure and the pattern of muscle contractions in the esophagus. A catheter is passed through the nose or mouth into the esophagus, which records the muscle contractions during swallowing. It is primarily used to evaluate conditions that affect esophageal motility, such as achalasia, gastroesophageal reflux disease (GERD), and dysphagia. 

pH Monitoring / Impedance Testing

• pH Monitoring is a procedure that measures the acidity in the esophagus over a 24-hour period. It is commonly used to diagnose GERD by detecting abnormal acid reflux episodes that may cause symptoms such as heartburn, regurgitation, or chest pain. 
• Impedance Testing is combined with pH monitoring to evaluate non-acidic reflux episodes, which are not detected by pH monitoring alone. It measures changes in electrical impedance in the esophagus when food or liquids move through, helping to identify both acid and non-acid reflux. 

Gastric Emptying Study 

This diagnostic test is used to evaluate how well the stomach empties its contents into the small intestine. The test measures the time it takes for food to leave the stomach. It is commonly used to diagnose conditions such as gastroparesis. Abnormal results can also indicate other disorders like mechanical obstructions or motility issues.

Anorectal Manometry

This diagnostic procedure is used to assess the function of the muscles in the rectum and anus. The test measures the pressure and coordination of the anal sphincter muscles and the rectum during rest, contraction, and relaxation. It is used to diagnose anorectal dysfunctions such as fecal incontinence, constipation, and difficulty passing stool, as well as to evaluate the functioning of the anal sphincters.

Biopsy and Tissue Analysis

Often performed during endoscopy for histopathology.

Mucosal Biopsy

A mucosal biopsy involves the removal of a small tissue sample from the mucosal lining of the gastrointestinal tract (or other organs) for examination under a microscope. The tissue sample is analysed for abnormal cell growth, infection, or signs of inflammation, helping guide treatment decisions and confirm diagnoses.

Fine Needle Aspiration (FNA)

This is a minimally invasive diagnostic procedure used to obtain a tissue sample from a suspicious lump or mass, from the liver, pancreas, thyroid, or lymph nodes. It helps in diagnosing conditions like cancer, infections, or benign tumors. The samples are analysed to determine the nature of the growth, whether it is benign or malignant, and to guide further treatment planning. 

Specialized Tests

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a specialised procedure used to examine and treat problems in the bile ducts, gallbladder, and pancreas. ERCP is used to diagnose and treat conditions like gallstones, bile duct strictures, pancreatitis, and bile duct cancer. It can also be used for procedures such as stone removal, stent placement, and biopsy collection for further testing.

Hydrogen Breath Tests

This is a non-invasive diagnostic test used to evaluate conditions like lactose intolerance, small intestinal bacterial overgrowth (SIBO), and fructose malabsorption. The test works by measuring the amount of hydrogen in the breath after ingesting a specific sugar, such as lactose or glucose. It is used for identifying digestive disorders that cause symptoms like bloating, diarrhea, and abdominal pain.

Get a free second opinion on gastroenterology tests and diagnosis.

At PACE Hospitals, we are committed to providing our patients with the best possible care, and that includes offering second medical opinions with super specialists for treatment or surgery. We recommend everyone to get an expert advance medical second opinion, before taking decision for your treatment or surgery.