By Dr Pranab Gyawali, Consultant Gastroenterologist (UK-trained) in Dubai
Introduction
If you are currently using a calprotectin stool test to monitor Crohn’s disease or ulcerative colitis, this is important.
The way I think about this in clinic is simple.
We are moving toward a next generation stool test in IBD that goes beyond simply detecting inflammation and starts reflecting what is actually driving disease activity.
Watch the Video
A shift I’ve seen over 15 years
I still remember being part of the team introducing calprotectin testing in my hospital in London nearly 15 years ago.
At the time, it completely changed how we monitored inflammatory bowel disease. For the first time, we had a reliable, non-invasive stool test that allowed us to monitor inflammation without repeatedly relying on invasive procedures.
Today, I am preparing to bring the next generation of stool testing to my patients here in Dubai.
What is this next generation stool test?
A recent paper published in Nature Biomedical Engineering has highlighted a promising new biomarker called Granzyme A.
Read the original Nature Biomedical Engineering paper
This is not just another inflammation marker.
It reflects active immune activity in Crohn’s disease and ulcerative colitis.
What happens during an IBD flare
During an active flare:
- Immune T cells become overactive
- These cells directly attack the gut lining
- As they do this, they release Granzyme A
What matters more than people realise is this:
- Granzyme A enters the lumen of the bowel
- It becomes part of the stool
- And this allows it to be detected with a stool test
Granzyme A vs Calprotectin stool test
This is the key difference.
- Calprotectin stool test: detects general inflammation
- Granzyme A stool test: detects active immune attack by T cells
This is a much more specific signal for inflammatory bowel disease.
Why this matters in real clinical practice
The mistake I often see is assuming all inflammation is the same.
In reality, the more important question is:
Is the immune system actively driving disease right now?
This is where a next generation stool test in IBD could become very useful.
- It may help distinguish active disease from background inflammation
- It may help identify early signs of flare
- It may improve monitoring of Crohn’s disease and ulcerative colitis
When will this be available?
Because this is a diagnostic stool test rather than a drug, development timelines are shorter.
Commercial translation is already moving forward.
This type of next generation stool test in IBD is likely to become available within the next 12–24 months.
FAQ
Is Granzyme A stool test available in Dubai?
The Granzyme A stool test is not yet widely available in Dubai but is expected within the next 12–24 months.
What is a Granzyme A stool test in Crohn’s disease?
It is a stool test that measures immune activity by detecting enzyme release from activated T cells.
What is a Granzyme A stool test in ulcerative colitis?
It is a stool biomarker that reflects immune-driven inflammation in ulcerative colitis.
How is Granzyme A different from calprotectin stool test?
Calprotectin detects general inflammation, while Granzyme A reflects active immune attack, making it more specific for IBD.
Can Granzyme A detect IBD flares?
Granzyme A has the potential to detect active flares more precisely because it reflects immune activity rather than general inflammation.
Recommended Guides
- Crohn’s Disease
- Ulcerative Colitis
- Inflammatory Bowel Disease (IBD)
- Gut Microbiome in Crohn’s and Ulcerative Colitis
Biologics and IBD Treatment
- Learn about Biologicals used in UC and Crohn’s in Dubai
- Tremfya (Guselkumab) in Ulcerative Colitis
- Stelara vs Skyrizi in Crohn’s disease
- Rinvoq (Upadacitinib) in Crohn’s and colitis
- Vedolizumab response prediction
Gut Microbiome, Diet and IBD Drivers
- Diet and microbiome in Crohn’s and ulcerative colitis
- SIBO in Crohn’s and ulcerative colitis
- Leaky gut in IBD
- Vitamin D and gut health
- Supplements and gut health
- Gut microbiome test
- Hydrogen and methane breath test
- Colonoscopy
- Capsule endoscopy
- MRI abdomen / MR enterography
- CT abdomen / CT enterography
If you wish to discuss this further or would like to make an appointment, please use the booking form on this page.