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Among noninvasive markers of pancreatic exocrine secretory function, fecal elastase is considered the best 1. Digestion of food requires, among other things, adequate levels of digestive enzymes secreted into the GI tract by the pancreas. Elastase, produced in the pancreas, is a proteolytic enzyme that breaks down dietary protein to absorbable amino acids and peptides. Fecal elastase levels are utilized to diagnose poor digestive capacity due to pancreatic exocrine function that may be associated with chronic pancreatitis, cystic fibrosis, carcinoma of the pancreas, Diabetes mellitus 1, and other etiologies of pancreatic enzyme insufficiency (eg. aging). 1,2,3,4,5 DDI uses a highly sensitive and specific immunoassay (ELISA) to measure human fecal elastase (does not recognize supplemental bovine or porcine elastase) 6 , and levels are similar for children and adults. 1 The elastase test has high diagnostic accuracy for patients with pancreatic digestive/malabsorption disorders. 5
1 Miendje Y, Maisin D, Sipewa M et al. Polyclonal versus monoclonal ELISA for the determination of fecal elastase 1: diagnostic value in cystic fibrosis and chronic pancreatic insufficiency. Clin. Lab. 2004; 50:419-424
2 Glassbrenner B, Schon A, Klatt S et al. Clinical evaluation of the fecal elastase test in the diagnosis and status of chronic pancreatitis. Eur. J. Gastroenterol. Hepatol. 1996; 11:1117-11120
3 Nune A, Pontes J, Rosa A et al. Screening for pancreatic exocrine insufficiency in patients with Diabetes mellitus. Am. J. Gastroenterol. 2003; 98:2672-2675
4 Deprez P, Del Natele M, Paulwels S et al. Comparative evaluation of C-mixed triglyceride breath test and faecal elastase l tests in the assessment of exocrine pancreatic insufficiency. AGA Abstracts, Gastroenterol. 2002; 122:A-51
5 Carroccio A, Verghi F, Santini Bet al. Diagnostic accuracy of fecal elastase 1. Assay in patients with pancreatic maldigestion or intestinal malabsorption. Dig. Dis. Sci. 2001;46:1335-1342
6Dominguez-Munoz J, Hieronymus C, Sauerbruch T et al. Fecal elastase test: evaluation of a new noninvasive pancreatic function test. Am. J. Gastroenterol. 1995; 90:1834-1837
Elastase, stool
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