Digestive Panel

The Digestive Panel combines four stool and blood tests: faecal calprotectin and occult blood, and Helicobacter pylori typing and the Gastro Panel from blood. It is used for persistent digestive symptoms when a doctor wants to assess signs of intestinal inflammation, hidden bleeding or changes in the stomach lining without endoscopy. The panel does not replace gastroscopy or colonoscopy.

Who the panel is for

• people with persistent pain, burning or discomfort in the upper abdomen;
• people troubled by bloating and early fullness for an extended period;
• people with diarrhoea or loose stools lasting for weeks;
• people with persistent abdominal pain and a change in bowel habits;
• people whose doctor is deciding whether endoscopic investigations are needed.

See a doctor without delay if you have blood in your stool, lose weight unintentionally, have difficulty swallowing or wake at night because of diarrhoea. If you vomit blood, have black, tarry stools or sudden severe abdominal pain, seek emergency care immediately. Do not wait for the panel results in these situations. If you are between 50 and 74 years old, also participate in the National Colorectal Cancer Early Detection Programme; the panel does not replace it.

What the panel includes

Test	Sample	What it indicates
Calprotectin (qualitative)	stool	inflammation of the intestinal lining
Faecal occult blood	stool	blood in the stool that is not visible to the naked eye
Helicobacter pylori typing	blood	antibodies to H. pylori bacteria
Gastro Panel (pepsinogen I and II, gastrin-17)	blood	condition of the stomach lining

Calprotectin

Calprotectin is a protein from neutrophils, white blood cells that accumulate at sites of inflammation. When the intestinal lining is inflamed, more calprotectin passes into the stool. The test helps distinguish inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, from conditions without inflammation, such as irritable bowel syndrome. In this panel, calprotectin is measured qualitatively, so the result is positive or negative without a numerical value. Read more in the article about calprotectin.

Faecal occult blood

The immunochemical test detects human haemoglobin in stool, meaning bleeding that is not visible to the naked eye. Such bleeding most often originates in the colon, for example from polyps, haemorrhoids, inflammation or cancer. Read more in Faecal occult blood.

Helicobacter pylori typing

Blood is tested for antibodies to Helicobacter pylori bacteria, specifically to its individual proteins. A positive result means the body has been exposed to the bacteria, and antibodies may remain in the blood for months after treatment. To check treatment success, the European Maastricht VI/Florence guidelines recommend a breath test or an H. pylori stool antigen test, no earlier than 4 weeks after treatment. The stool test is not part of the panel.

Gastro Panel

The Gastro Panel measures pepsinogen I and II and gastrin-17, substances produced by the stomach lining. Their levels and ratios indicate whether the stomach lining is thinned, meaning atrophic gastritis is present. This condition is associated with vitamin B12 deficiency and a higher risk of stomach cancer. Read more in the article about the Gastro Panel.

Preparation and samples

Blood sampling

• Arrive fasting, preferably in the morning after an overnight fast: do not eat, drink or smoke for at least 4 hours before blood sampling.
• If you take medicines to reduce stomach acid (e.g. pantoprazole, omeprazole or esomeprazole), tell staff when your blood is taken, because they affect Gastro Panel values. Discuss with your doctor whether to stop them temporarily before testing.
• If possible, omit herbal preparations and supplements for a week beforehand.

Stool sample

Collect stool on a clean, dry surface without mixing it with urine or toilet water, transfer a small amount into a stool container and bring the sample in as soon as possible. The occult blood test requires 3 stool samples. You do not need to change your diet. Postpone sampling during menstruation, haemorrhoidal bleeding or an acute intestinal infection, such as viral gastroenteritis. Painkillers and anti-inflammatory medicines (e.g. ibuprofen, diclofenac and acetylsalicylic acid) can raise calprotectin and cause a positive occult blood test. Consult your doctor about your medicines; do not stop treatment yourself.

How results are interpreted

Each test has its own result, and the doctor interprets them together with your symptoms and examination:

• positive calprotectin suggests intestinal inflammation but does not identify the cause: this may be inflammatory bowel disease, infection or the effect of medicines;
• a positive occult blood test means blood was found in the stool and requires further investigation, most often colonoscopy; a negative result does not rule out polyps or cancer;
• positive H. pylori antibodies mean the body has been exposed to the bacteria; a doctor decides on treatment, sometimes only after confirming active infection;
• abnormalities in the Gastro Panel may suggest inflammation or thinning of the stomach lining, which a doctor usually investigates with gastroscopy.

How to arrange testing

You can have blood taken without an appointment or referral at one of our branches across Croatia (listed on the Contact page). Every branch accepts stool samples. Prices for all tests and panels are available in the service price list.

Frequently asked questions

Can the Digestive Panel replace gastroscopy or colonoscopy?

No. The panel provides guidance: it shows signs of inflammation, bleeding or changes in the lining, but cannot show where a change is or what it is. A gastroenterologist diagnoses stomach and bowel disease, most often by endoscopy with tissue sampling.

How is successful Helicobacter treatment confirmed?

Under European guidelines, follow-up uses a stool antigen test or breath test, no earlier than 4 weeks after the last antibiotic dose and after 2 weeks without proton pump inhibitors. A doctor decides on the method and timing of follow-up.

Does the panel detect colorectal cancer?

The occult blood test is used for colorectal cancer screening, but a positive result is not a diagnosis and a negative result does not rule out disease. Calprotectin can be elevated in some tumours but is not a test for detecting them. Diagnosis is confirmed by colonoscopy.