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Laboratory: Clinical Biochemistry
Test Name:
Test Code: MISC
Clinical Information:
Test Indications: Fecal elastase  testing  is used for the diagnosis of exocrine pancreatic insufficiency resulting in fat malabsorption.
This test is only available to Hepatology and Gastroenterology specialists, and requires prior approval by a Clinical Biochemist.
Click here for the Approval for Test Referral Biochemistry form (F260-11-02)
Recommendations: Steatorrhea should be confirmed by Fat (Neutral and Split) Qualitative testing prior to ordering this test.

Pancreatic Elastase-1 is an enzyme produced by pancreatic acinar cells and plays an important role in digestion. Its measurement is indicated for the diagnosis of Exocrine Pancreatic Insufficiency (EPI). Clinical symptoms of EPI include: weight loss, abdominal pain, bloating, steatorrhea, and chronic diarrhea. EPI is most commonly caused by chronic pancreatitis or as a consequence of gastrointestinal surgery, especially the Whipple procedure. EPI may also be observed in patients with Cystic Fibrosis or Schwachman-Diamond syndrome.
Total pancreatic enzyme production can be estimated by measuring Elastase-1 concentrations in feces. Decreased Elastase-1 is strongly suggestive of EPI.
Leeds JS, Oppong K, and Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011; 8(7): 405-415.

Vanga RR, Tansel A, Sidig S, et al. Diagnostic Performance of Measurement of Fecal Elastase-1 in Detection of Exocrine Pancreatic Insufficiency: Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2018; 16: 1220-1228.
Collection Devices:
Preferred Device:
1 - Sterile Specimen Container (100 mL)

Sterile Specimen Container (100 mL)

Catalogue #:
 - Collect a random feces specimen and submit to the lab as soon as possible.
Specimen Required:
Feces : 5.0 g

Additional specimens should be collected if other tests are also being ordered.

Any specimen received refrigerated or at ambient temperature more than 72 hours post-collection will be rejected. Store and ship frozen.
Reference Values:
<100 µg/g:  Strongly suggestive of Pancreatic Insufficiency
100 - 200 µg/g:  Suggestive of moderate Pancreatic Dysfunction
≥200 µg/g:  Suggestive of Pancreatic Sufficiency
Reference values apply to all ages.
Within 4 Weeks
See Also:
More Information:
Specimen Handling: Specimen must be stored and shipped frozen.
Test is performed at In-Common Labs
Test Name: Elastase 1, Feces