Elastase is a pancreatic enzyme that digests and degrades a number of proteins. A finding of low elastase in a formed stool specimen is an indicator of pancreatic exocrine insufficiency. Moderate pancreatic insufficiency is defined at 100-200 μg/mL, and severe pancreatic insufficiency as <100 μg/mL. Fecal elastase can be artefactually low due to fluid dilution effects in a loose/watery stool sample. Check the
reported consistency of the stool specimen.
Fecal elastase measured by a sensitive immunoassay is a specific marker for pancreatic function and maintains a high diagnostic accuracy among patients with small intestinal diseases. This elastase marker allows for the diagnosis or exclusion of pancreatic exocrine insufficiency and degree of severity, which can be caused by chronic pancreatitis, cystic fibrosis, pancreatic tumor, cholelithiasis or diabetes mellitus.
This test does not differentiate between pancreatic insufficiency due to chronic pancreatitis and that due to pancreatic cancer. Immunoreactive elastase concentrations are similar for children and adults. In cases of severe exocrine pancreatic insufficiencies, fecal fat stain may also be elevated. Supplementation with pancreatic enzymes, minerals, and vitamins may be warranted.
Elastase is a pancreatic enzyme that digests and degrades a number of proteins. A finding of low elastase in a formed stool specimen is an indicator of pancreatic exocrine insufficiency.
Moderate pancreatic insufficiency is defined at 100-200 μg/mL, and severe pancreatic insufficiency as <100 μg/mL.
Fecal elastase can be artefactually low due to fluid dilution effects in a loose/watery stool sample. Check the
reported consistency of the stool specimen.
What is pancreatic insufficiency?
Pancreatic Insufficiency (EPI) is a condition which occurs when the pancreas does not make enough of a specific enzyme the body uses to digest food in the small intestine.
The pancreas is a glandular organ. That means the pancreas secretes juices that maintain the proper function of the body. The pancreas produces both enzymes and hormones.
Symptoms may include:
- abdominal pain and tenderness
- loss of appetite
- feelings of fullness
- weight loss and diarrhea
Pancreatic insufficiency may also cause bone pain and muscle cramps.
What causes pancreatic insufficiency?
When the pancreas becomes damaged, pancreatic enzymes are not produced, and malabsorption results. Malabsorption is the result of food that is not properly converted into usable energy by the digestive system.
The pancreas may become damaged by:
- recurring inflammation of the pancreas
- previous pancreatic surgery
- it is rarely caused by cancer
Additionally, there are genetic factors that may cause damage to the pancreas:
- cystic fibrosis, a disease damages glandular organs by creating mucus that impairs their function
- Shwachman-Diamond Syndrome, a rare autosomal recessive disorder
Treatment of pancreatic insufficiency:
When chronic pancreatitis is discovered, attempts are made to remove causative factors.
- reduce high blood fat (triglyceride) levels
- reduce alcohol use or abuse
- stimulate pancreatic duct drainage using dilation, or stents
- surgery
There are reports of the use of antioxidants (selenium, vitamin A, vitamin C, and vitamin E) to reduce ongoing inflammation.
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There are no problems recorded in medical literature for high levels of Pancreatic Elastase.
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