A pancreatic elastase test measures the amount of elastase in a stool sample. Often called a fecal elastase or stool elastase test, it helps doctors identify exocrine pancreatic insufficiency (EPI), a condition in which the pancreas doesn’t make or release enough digestive enzymes to properly break down food.
Low fecal elastase levels may be a sign of conditions that affect the pancreas, including chronic pancreatitis, cystic fibrosis and pancreatic cancer. While the test alone cannot diagnose pancreatic cancer, abnormal results may lead doctors to recommend additional testing to better understand the cause of symptoms and assess pancreatic health.
In this article, we take a closer look at the pancreatic elastase test, including:
- What does the test measure?
- How is a stool elastase test performed?
- What do the results mean?
- Symptoms that should prompt a doctor visit
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.
What Does the Test Measure?
A pancreatic elastase test measures the amount of elastase — a digestive enzyme produced by the pancreas — in a stool sample. Elastase helps the body break down fats, proteins and carbohydrates during digestion.
“Doctors often order this test for people with unexplained gastrointestinal symptoms — such as chronic diarrhea, bloating, abdominal pain, weight loss or greasy stools,” says Mustafa Raoof, M.D., M.S., a surgical oncologist and researcher at City of Hope® Cancer Center Duarte specializing in gastrointestinal cancers. “It helps us determine how well the pancreas is functioning.”
How is a Stool Elastase Test Performed?
A stool elastase test is performed using a stool sample collected at home or in a medical setting. The process may vary slightly by provider or laboratory, but common collection methods include those listed below.
Using a collection container: A small plastic container or device is placed over the toilet to catch the stool sample before it touches the water.
Using plastic wrap: Some people may be instructed to loosely place plastic wrap over the toilet bowl to collect the sample.
Using a scoop or applicator: A small amount of stool is collected in a sterile container provided by the healthcare team or laboratory.
Sending the sample to a lab: The sample is sealed and returned to a lab or healthcare provider for testing.
The test itself is noninvasive and doesn’t require special procedures. Most people may continue taking their usual medications, including pancreatic enzyme replacement therapy, before the test, although patients should always follow their doctor’s instructions.
What Do the Results Mean?
A pancreatic elastase test measures how much elastase — a digestive enzyme made by the pancreas — is present in stool. In terms of results, if little or no elastase is found, it may mean the pancreas is not making or releasing enough digestive enzymes. This condition is called exocrine pancreatic insufficiency, or EPI for short. EPI may be linked to pancreatic cancer, chronic pancreatitis, cystic fibrosis, diabetes and other gastrointestinal conditions.
Generally, pancreatic elastase test results are interpreted as follows.
Over 200 micrograms per gram (mcg/g): Normal pancreatic function. The patient’s pancreas is likely making and releasing enough digestive enzymes.
100–200 mcg/g: Mild to moderate EPI. Additional testing or follow-up may be needed.
Under 100 mcg/g: Severe EPI. This may signal a more serious pancreas-related problem.
Under 200 mcg/g overall: May suggest EPI or another condition affecting digestion and pancreatic function.
“Importantly, a pancreatic elastase test on its own cannot diagnose pancreatic cancer or another disease,” Dr. Raoff says. “We interpret the results together with symptoms, imaging scans and other tests to more fully understand what may be causing digestive problems.”
Symptoms That Should Prompt a Doctor Visit
Digestive symptoms that don’t go away or worsen over time may be a sign that the pancreas isn’t working properly and should be evaluated by a doctor.
Symptoms that should prompt a doctor visit include:
- Unexplained abdominal pain
- Unexplained weight loss
- Chronic diarrhea
- Constipation
- Steatorrhea (greasy, oily or foul-smelling stools)
- Excessive gas or flatulence
- Bloating after meals
- Food intolerances or difficulty digesting certain foods
- Changes in appetite
- Signs of poor nutrient absorption (malabsorption), such as fatigue or vitamin deficiencies
These symptoms may have various possible causes, including EPI, chronic pancreatitis and pancreatic cancer.
If you or a loved one is concerned about possible signs or symptoms of cancer and would like an initial consultation or a second opinion, call us 24/7 at 877-460-4673.