Monitoring, Screening, and Investigating Beyond Initial Diagnosis
Once initial digestive symptoms have been investigated, many patients need a deeper level of testing, whether to monitor an inflammatory bowel condition, screen for cancer risk, or investigate pancreatic function. This guide covers that specialist panel offered at Altus Lab.
If you’re earlier in your diagnostic journey, investigating symptoms like bloating, suspected celiac disease, or possible H. pylori infection, read our companion guide to celiac and digestive infection tests covering that starting panel.
Every test here is supervised by Dr. Alok Gupta, MD Pathology, Ex-PGIMER Chandigarh, with home sample collection available across Chandigarh, Mohali, and Panchkula for blood-based tests.
Faecal Calprotectin
Faecal Calprotectin measures a protein released by white blood cells during intestinal inflammation, making it one of the most valuable tests available for distinguishing between Inflammatory Bowel Disease, such as Crohn’s disease or ulcerative colitis, and Irritable Bowel Syndrome, a functional condition that doesn’t involve actual inflammation.
This distinction matters enormously in clinical practice, since IBD and IBS require completely different management approaches, yet can present with remarkably similar symptoms including abdominal pain, altered bowel habits, and bloating. Calprotectin testing helps avoid unnecessary invasive procedures like colonoscopy in patients who genuinely have IBS rather than IBD.
At Altus Lab, we also recommend this test for patients with already diagnosed IBD, since calprotectin levels help monitor disease activity over time, allowing doctors to assess treatment effectiveness and detect flares before symptoms become severe.
ANCA (Perinuclear ANCA) & ASCA (Anti-Saccharomyces)
This combined panel tests for two distinct antibodies that help distinguish between the two main types of Inflammatory Bowel Disease. Perinuclear ANCA appears more frequently in ulcerative colitis, while ASCA appears more commonly in Crohn’s disease, making this panel genuinely useful for clarifying which specific IBD subtype a patient has.
This distinction directly influences treatment decisions, since Crohn’s disease and ulcerative colitis, despite both falling under the IBD umbrella, often respond differently to specific medications and sometimes require different surgical approaches when medication alone isn’t sufficient to control the disease.
At Altus Lab, we recommend this panel for patients with confirmed IBD where the specific subtype remains unclear from colonoscopy and biopsy findings alone, since antibody patterns can provide additional supporting evidence to guide your gastroenterologist’s treatment planning.
Fecal Elastase (FE-II)
Fecal Elastase measures an enzyme produced by the pancreas that should remain stable as it passes through the digestive system, making low levels a reliable indicator of pancreatic exocrine insufficiency, a condition where the pancreas fails to produce adequate digestive enzymes for proper food absorption.
This test proves particularly valuable because it’s genuinely non-invasive, requiring only a stool sample rather than more invasive pancreatic function testing, yet still provides reliable evidence of pancreatic enzyme production. Patients with unexplained weight loss, fatty stools, or chronic diarrhoea alongside known pancreatic conditions benefit significantly from this test.
At Altus Lab, we recommend Fecal Elastase testing for patients with chronic pancreatitis, cystic fibrosis, or unexplained malabsorption symptoms, since identifying pancreatic insufficiency opens the door to enzyme replacement therapy, which can meaningfully improve digestion and nutritional status once correctly diagnosed.
CEA (Carcinoembryonic Antigen)
CEA is a tumour marker most commonly associated with colorectal cancer, though it can also be elevated in several other cancer types and even some non-cancerous conditions, making it most useful as a monitoring tool rather than a standalone screening test for the general population.
Doctors primarily use CEA testing to monitor patients already diagnosed with colorectal cancer, tracking levels before and after treatment to assess response, and watching for rising levels afterward that might indicate cancer recurrence before it becomes detectable through imaging alone.
At Altus Lab, we process CEA testing both for newly diagnosed cancer patients establishing a baseline and for patients in ongoing surveillance after treatment, understanding that consistent, reliable monitoring genuinely matters for catching potential recurrence at the earliest possible stage.
CA 19-9 (Carbohydrate Antigen 19-9)
CA 19-9 is the most widely used tumour marker for pancreatic cancer, though it also shows elevation in certain bile duct cancers and some non-cancerous pancreatic and liver conditions, meaning results always require careful clinical interpretation rather than standing alone as a definitive answer.
This test proves particularly valuable for monitoring patients already diagnosed with pancreatic cancer, tracking treatment response and watching for recurrence, since pancreatic cancer often lacks early symptoms, making any available monitoring tool genuinely valuable once a diagnosis has been established.
At Altus Lab, we recommend CA 19-9 testing for patients with diagnosed pancreatic or biliary tract cancer requiring ongoing monitoring, and as supporting evidence, alongside imaging, when pancreatic cancer is clinically suspected but not yet confirmed through other means.
AFP (Alpha-Fetoprotein)
AFP is a tumour marker primarily associated with liver cancer, particularly hepatocellular carcinoma, making it a valuable screening and monitoring tool for patients with chronic liver disease, cirrhosis, or hepatitis B or C infection, all conditions that significantly increase liver cancer risk over time.
Beyond liver cancer, AFP also plays an important role in certain germ cell tumours, giving this test relevance beyond gastroenterology alone. However, elevated AFP doesn’t automatically confirm cancer, since levels can rise during pregnancy and in certain benign liver conditions too.
At Altus Lab, we recommend regular AFP monitoring for patients with chronic liver disease or cirrhosis as part of liver cancer surveillance, typically alongside periodic liver imaging, since catching liver cancer at an early, more treatable stage significantly improves long-term outcomes.
Serum Gastrin Level
Serum Gastrin measures a hormone that stimulates stomach acid production, and elevated levels can point toward several conditions, most notably Zollinger-Ellison Syndrome, a rare condition where a gastrin-producing tumour causes excessive acid production, leading to severe, recurrent peptic ulcers that don’t respond well to standard treatment.
This test becomes particularly relevant for patients with peptic ulcers that keep recurring despite appropriate treatment, or ulcers appearing in unusual locations, since these patterns suggest an underlying cause beyond typical H. pylori infection or medication-related ulcers that standard treatment usually resolves.
At Altus Lab, we recommend Gastrin testing when a patient’s ulcer disease doesn’t follow the expected treatment response pattern, since identifying an underlying gastrin-producing tumour, while rare, changes the entire treatment approach from standard acid suppression to addressing the root hormonal cause.
Pancreatic Enzyme Panel (Amylase, Lipase)
The Pancreatic Enzyme Panel measures amylase and lipase, two enzymes released into the blood when the pancreas becomes inflamed or damaged, making this combination the primary blood test doctors rely on when diagnosing acute pancreatitis, a genuinely painful and potentially serious condition requiring prompt recognition.
Lipase generally offers better accuracy than amylase alone, remaining elevated for a longer window after an acute episode begins, while amylase can rise and fall more quickly. Testing both together gives doctors the most complete picture, particularly important in the emergency setting where rapid, accurate diagnosis directly affects treatment decisions.
At Altus Lab, we prioritise rapid processing for this panel, since acute pancreatitis often requires urgent treatment decisions, and confirming or ruling out this diagnosis quickly helps doctors determine the appropriate level of care a patient needs without unnecessary delay.
How to Book IBD, Cancer Marker & Pancreatic Testing at Altus Lab
Several tests in this category, particularly pancreatic enzyme testing for suspected acute pancreatitis, are genuinely time-sensitive. Call or WhatsApp our team, share your prescription, and we will confirm which tests you need and prioritise urgent cases accordingly.
📞 Call: 0172-5017001 / 0172-5017002
💬 WhatsApp: +91-62842-14977
📍 SCO 35, Sector 16-D, Chandigarh
🕐 Open 7 Days: 7:30 AM – 9:30 PM
Home sample collection is available for blood-based tests across Chandigarh, Mohali, and Panchkula.
Frequently Asked Questions
1. Can Faecal Calprotectin replace a colonoscopy for IBD diagnosis?
No. This test helps distinguish between likely IBD and IBS, guiding whether colonoscopy is necessary, but it cannot replace colonoscopy for definitive IBD diagnosis and staging.
2. Do I need both CEA and CA 19-9 testing?
These markers target different cancer types and situations. Your doctor will recommend the specific marker relevant to your clinical situation rather than ordering both routinely.
3. Can AFP testing detect liver cancer early in someone without liver disease?
AFP is most useful for monitoring patients already at elevated risk, such as those with cirrhosis or chronic hepatitis, rather than as a general screening test for the average person.
4. How urgent is the Pancreatic Enzyme Panel for suspected pancreatitis?
This test is genuinely urgent, since acute pancreatitis requires prompt diagnosis and treatment. Altus Lab prioritises rapid processing whenever this is clinically flagged.
5. What does elevated ANCA or ASCA actually confirm?
These antibodies provide supporting evidence for IBD subtype classification but don’t replace colonoscopy and biopsy for definitive diagnosis; they add useful context alongside those findings.
6. Is fasting required before pancreatic enzyme testing?
Fasting is generally not required for amylase and lipase testing, though your doctor may provide specific instructions based on your individual clinical situation.
7. Why would Gastrin levels be tested for recurring ulcers?
Persistently recurring ulcers despite standard treatment can indicate an underlying gastrin-producing tumour, a rare but important cause that requires a completely different treatment approach once identified.
8. Who reviews these results at Altus Lab?
All IBD, cancer marker, and pancreatic tests are supervised by Dr. Alok Gupta, MD Pathology, Ex-PGIMER Chandigarh, ensuring accurate, clinically reviewed reporting.