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Stool Elastase

What is a stool elastase test?

This test measures the amount of elastase in your stool. Elastase is an enzyme made by special tissue in the pancreas, an organ in your upper abdomen. Elastase helps break down fats, proteins, and carbohydrates after you eat. It's a key part of your digestive process.

In a healthy pancreas, elastase will be passed in the stool. If little or no elastase is found in your stool, it can mean this enzyme isn't working as it should. This is called pancreatic insufficiency. Pancreatic insufficiency can cause a number of health problems, including malabsorption and malnutrition, disorders that affect your ability to digest and take in nutrients from food.

In adults, pancreatic insufficiency is often a sign of chronic pancreatitis. Pancreatitis is an inflammation of the pancreas. Chronic pancreatitis is a long-lasting condition that tends to get worse over time. It can lead to permanent damage of the pancreas. Acute pancreatitis, another form of the disease, is a short-term condition. It is usually diagnosed with blood and/or imaging tests, rather than a stool elastase test.

In children, pancreatic insufficiency can be a sign of:

• Cystic fibrosis, an inherited disease that causes mucus to build up in the lungs, pancreas, and other organs
• Shwachman-Diamond syndrome, a rare, inherited disease that causes problems with the skeletal system, bone marrow, and pancreas

Other names: pancreatic elastase, fecal pancreatic elastase, fecal elastase, FE-1

What is it used for?

A stool elastase test is used to find out if there is pancreatic insufficiency. This test is better at finding severe pancreatic insufficiency, rather than mild or moderate cases.

Pancreatic insufficiency can sometimes be a sign of pancreatic cancer, but this test is not used to screen for or diagnose cancer.

Why do I need a stool elastase test?

You may need a stool elastase test if you or your child has symptoms of pancreatic insufficiency. These include:

• Abdominal pain
• Smelly, greasy stools
• Malabsorption, a disorder that affects your ability to digest and absorb nutrients from food. It can cause malnutrition, a condition in which your body does not get the calories, vitamins, and/or minerals needed for good health.
• Losing weight without trying. In children, this can delay growth and development.

What happens during a stool elastase test?

You will need to provide a stool sample. Your provider or your child's provider will give you specific instructions on how to collect and send in your sample. Your instructions may include the following:

• Put on a pair of rubber or latex gloves.
• Collect and store the stool in a special container given to you by your health care provider or a lab. You may get a device or applicator to help you collect the sample.
• Make sure no urine, toilet water, or toilet paper mixes in with the sample.
• Seal and label the container.
• Remove the gloves, and wash your hands.
• Return the container to your health care provider or the lab by mail or in person.

Will I need to do anything to prepare for the test?

If you are taking pancreatic enzyme supplements, you may need to stop taking them for five days before the test.

Are there any risks to the test?

There is no known risk to having a stool elastase test.

What do the results mean?

If your results show a low amount of elastase, it probably means you have pancreatic insufficiency. Your provider will probably order more tests to diagnose the cause of the insufficiency. These tests may include:

• Blood tests to measure levels of pancreatic enzymes
• Imaging tests to look at the pancreas and surrounding organs

Your child's health care provider may order different types of tests to help diagnose cystic fibrosis or Shwachman-Diamond syndrome.

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about a stool elastase test?

If you are diagnosed with chronic pancreatitis, there are treatments that can help manage your condition. Treatment usually includes dietary changes, medicines to manage pain, and/or pancreatic enzyme supplements you can take with each meal. Your provider may also recommend that you give up drinking alcohol and smoking.

If your child was diagnosed with cystic fibrosis or Shwachman-Diamond syndrome, talk to your child's provider about treatment options.