Ahmedabad: England pacer Jofra Archer was not considered for the fourth Test against India due to a persisting elbow injury and some of the squad members including Ben Stokes also have an upset stomach, the ECB said on Thursday.
Archer had missed the second Test in Chennai due to the same issue.
"Jofra Archer is not playing in this Test match due to his ongoing right elbow issue. The ECB medical team will provide an update in due course," read an update from the England cricket board.
"Ben Stokes has had an upset stomach, the same issue that has affected other members of the touring party. It is not expected to keep him off the field," it said.
Archer returned to play the third Test in which he picked up a wicket.
Stokes made a fine 55 on day one of the final Test. Veteran James Anderson is the only frontline pacer in the playing eleven.
The team has conceded a 1-2 lead in the four-match series and is out contention for a place in the World Test Championship final.
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The spin combination of left-armer Patel and off-spinner India vs England exploited the turning Motera pitch at the newly-inaugurated Narendra Modi stadium to the full and England's first innings folded in just 48.4 overs after the visitors opted to bat.
Senior wicketkeeper batsman Jonny Bairstow has also returned to the squad and it remains to be seen whether they can keep in-form Ben Foakes out or play both of them.
The series, tied at 1-1, has added significance with both teams in the hunt for a spot in the World Test Championship final.