Pathology tests database

Sample and container requirements

Faeces (universal container)

Minimum volume required

500 mg

Special requirements

Requires a formed stool specimen. Watery stool samples can give falsely low results.

Patient preparation

None

Sample viability

Turnaround time

15 days

Reference range

>200 µg/g: Normal 100 – 200 µg/g: Mild to moderate exocrine pancreatic insufficiency <100 µg/g: Severe exocrine pancreatic insufficiency (Source: Phillips et al., 2021, doi: 10.1136/bmjgast-2021-000643)

Clinical guidance

Pancreatic elastase is secreted by acinar cells in the pancreas. It is not degraded during transfer through the intestine, therefore, the faecal concentrations reflects pancreatic exocrine function. Faecal elastase is a non-invasive assessment of pancreatic exocrine insufficiency. Its measurement has been shown to correlate well with more invasive 'tube' and 'tubeless' tests of exocrine pancreatic function such as the Secretin Pancreozymin test and the Pancreolauryl test. Faecal elastase may also have role in the assessment of cystic fibrosis patients. Administration of bovine or porcine pancreatic supplements do not interfere with the test for faecal elastase, which is a distinct advantage over other pancreatic enzymes such as trypsin, chymotrypsin or amylase. Very wet stool samples may give falsely low elastase levels and require confirmation on a formed sample to confirm pancreatic exocrine insufficiency.

Notes