2198. Pancreatic elastase (stool)

Pancreatic elastase is a specific enzyme synthesized by pancreatic cells. Its detection in feces allows for an assessment of the pancreas's exocrine function. This noninvasive and sensitive test is used to diagnose pancreatic insufficiency, particularly in conditions such as chronic pancreatitis, cystic fibrosis, or diabetes.

Pancreatic elastase is a proteolytic enzyme produced by the acinar cells of the pancreas. It is secreted as proelastase along with other enzymes into the duodenum, where it is converted to elastase by trypsin. Along with other enzymes, it participates in digestion. The enzyme is not affected during its passage through the intestine. Pancreatic elastase levels are a standard marker for exocrine pancreatic insufficiency. Elastase levels are low in newborns and reach adult levels by two weeks of age. Pancreatic elastase activity is unchanged in celiac disease, inflammatory bowel disease, and infectious diarrhea.

The advantages of coprological detection of pancreatic elastase are that pancreatic elastase is absolutely specific to the pancreas, stable during intestinal transit, its concentration in feces reflects the secretory function of the pancreas, enzyme replacement therapy does not affect its concentration (the monoclonal antibodies used in the test do not interact with elastase of animal origin), and the results can be used to draw conclusions not only about the level of pancreatic enzyme deficiency, but also to evaluate the dynamics of exocrine function.

When?

• If there are signs of digestive problems: bloating, diarrhea, steatorrhea (fat in the stool), weight loss.
• If chronic pancreatitis is present or suspected.
• If cystic fibrosis (in children and adults).
• In patients with type 1 or type 2 diabetes mellitus – to detect concomitant pancreatic insufficiency.
• To monitor pancreatic function in cases of long-term alcohol abuse or gallstones.

Who should use it?

• Patients with chronic gastrointestinal diseases and suspected pancreatic dysfunction.
• Children with growth retardation, diarrhea, or underweight.
• People with diabetes, especially those with gastrointestinal complaints.
• People with a family history of pancreatic disease.

• Stool