What is a Stool Elastase Test?
Pancreas makes enzymes that help the body digest and break down fats, proteins, and carbohydrates. One of these enzymes is pancreatic elastase. This enzyme travels from pancreas to small intestine and remains in stool, even after digestion.
A stool elastase test, also called a faecal elastase test, measures the amount of pancreatic elastase enzyme in a stool sample. The result shows whether your pancreas is working properly to produce digestive enzymes or it has some abnormality.
Doctors use this test to check exocrine pancreatic insufficiency (EPI). This is a condition in which pancreas doesn’t release enough digestive enzymes to digest food, break it down, and absorb nutrients. It detects severe EPI more than mild pancreatic insufficiency.
Low elastase results may point to reduced pancreatic function, but this result alone cannot confirm the cause. A doctor may look at your symptoms, health history, and other test findings to interpret the results.
How is the Faecal Elastase Test Performed?
Preparation
Preparing for stool elastase test is simple.
- You don’t need to fast.
- Always follow the instructions provided by your healthcare provider or laboratory.
- Tell your provider about your ongoing medications, pancreatic enzyme supplements, or therapy.
- Do not stop taking medicines without your doctor’s instructions.
- Collect formed, or semi-formed/solid stool sample. Watery sample may compromise the test accuracy and give inaccurate readings.
Sample Collection
Labs provide a sterile container for stool sample. Follow the provided instructions carefully.
- Pass stool into a clean and dry collection surface.
- Do not mix sample with urine or toilet water.
- Close the lid of the container properly.
- Label the container if and as instructed.
- Wash your hands with soap and water.
- Return the sample as per laboratory’s instructions.
A very watery stool sample can dilute the elastase and make the result appear lower than it is. For this reason, a formed or semi-formed sample is preferred.
The lab will tell you if the sample needs refrigeration or temperature-controlled environment. Deliver sample within certain time.
Lab Analysis
The laboratory measures pancreatic elastase in the stool, usually with an immunoassay. Results are reported as micrograms of elastase per gram of stool (µg/g).
When Is Stool Elastase Test Recommended?
Unclear digestive symptoms may prompt your doctor to recommend this test. The symptoms can occur when body does not receive enough pancreatic enzymes for proper digestion.
Digestive Symptoms
- Frequent or ongoing diarrhoea
- Stools that appear oily and greasy
- Pale or foul-smelling stools
- Stools that float or are difficult to flush
- Bloating
- Excessive gas
- Abdominal pain or discomfort
Signs of Poor Nutrient Absorption
- Weight loss for no reason
- Difficulty gaining weight
- Poor growth in children
- Malnutrition
- Low levels of certain vitamins
- Tiredness linked to poor nutrition
These symptoms do not always mean that a person has EPI. Several digestive conditions can cause similar problems. Testing helps the healthcare provider decide whether the pancreas may be involved.
Conditions In Which This Test is Requested
A doctor may use this test to check pancreatic function in people with:
- Chronic pancreatitis
- Cystic fibrosis
- Diabetes
- Previous pancreatic surgery
- Pancreatic cancer
- Some issues related to small intestine
- Previous surgery involving the digestive system
What are Normal Ranges for Stool Elastase Test?
- More than 200 µg/g: Usually consistent with normal pancreatic enzyme production
- 100–200 µg/g: Indeterminate result that may need further assessment
- Less than 100 µg/g: Provides stronger evidence of EPI when the symptoms and clinical findings also support it
A result above 200 µg/g means the chances of moderate or severe pancreatic insufficiency are less likely. However, it may not completely rule out a mild problem.
The reference ranges vary depending on the laboratory and the methodology used. Individuals must consult their healthcare provider for correct interpretation of the results.
What Do Abnormal Results Mean?
Low Stool Elastase Levels
A low result, less than 100 µg/g, means pancreatic elastase found in the stool was less than normal, indicating that the pancreas is not releasing enough digestive enzymes.
Possible causes include:
- Chronic pancreatitis
- Cystic fibrosis
- Pancreatic cancer
- Previous pancreatic surgery
- Acute or repeated pancreatitis
- Long-standing diabetes
- Certain intestinal conditions
- Previous surgery on the digestive system
A low value does not identify the cause by itself. It must be considered together with symptoms, medical history and other findings.
Indeterminate Results
A result between 100 and 200 µg/g needs careful interpretation. Your healthcare provider may recommend repeating the test, when:
- The sample was watery
- The symptoms do not match the result
- No known risk factors found for pancreatic disease
- Mild EPI is still suspected
The Stool Elastase Test is better at finding severe pancreatic insufficiency than mild disease. Further assessment may therefore be needed even when the result is not clearly low.
What May Happen Next?
A qualified doctor takes decisions based on overall medical history and symptoms of the patient.
Your doctor may request other investigations based on your results. These can include blood tests, nutritional tests or imaging of the pancreas.
In case EPI is confirmed, doctor focuses on its cause and severity. Treatment may involve pancreatic enzyme replacement therapy (PERT). Nutritional support and checks for vitamin deficiencies, such as A, D, E, and K can also be the part of treatment and care plan.
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