Fecal Elastase, stool

Pancreatic elastase 1 or fecal elastase is a human pancreas specific enzyme. It has a molecular weight of 28 kDa with high affinity to the carboxyl group of alanine, valine, and leucine, and is highly stable during passage through the gastrointestinal tract. FE-1 is enriched 5-6 fold in the feces compared with pancreatic juices and can be used as an indicator of pancreatic exocrine function. Fecal elastase concentrations are decreased in patients with pancreatic insufficiency, with concentrations less than 100 μg/g in stool considered severe pancreatic insufficiency and greater than 200 μg/g considered a normal level. Fecal elastase levels have been shown to correlate with other pancreatic function tests, such as the secretin-cholecystokinin or secretin-caerulein test. These tests are considered the “gold standard” test, however, they are invasive, time-consuming, and expensive. The benefits of fecal elastase to diagnose pancreatic insufficiency include non-invasiveness and it does not require patients to consume a special diet or discontinue pancreatic enzyme replacement therapy. [Adopted with modification from the manufacturer's package insert: DiaSorin LIAISON® Elastase-1 Version 2019-07].