Tod, Jo and Fine, David (2010) Fecal elastase: a useful test for pancreatic insufficiency? Digestive Diseases and Sciences, 55 (10), 2709-2711. (doi:10.1007/s10620-010-1409-9). (PMID:20838890)
Abstract
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Pancreatic fecal elastase-1 (FE-1) has become the first-line test of pancreatic function. Our experience as a referral center for pancreatic disease suggests that in the minds of most gastroenterologists, a low FE-1 is diagnostic of pancreatic insufficiency. The paper by Evans and colleagues in the current issue of this journal highlights some weaknesses of that assumption in patients with Celiac disease.
FE-1, first described by Balo and Banga in 1950 [1], is one of a family of protease enzymes secreted by acinar cells. FE-1 is well documented in quantitative studies to be stable during intestinal transit and studies demonstrate significant correlation between fecal elastase and levels of other pancreatic enzymes such as duodenal lipase, amylase, trypsin, and bicarbonate concentration [2–6]. Fecal elastase is concentrated in human feces compared with pancreatic juice and is a simple, non-invasive and inexpensive test [2, 7, 8]. As a result, FE-1 has replaced “tube tests” and fecal fat ...
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