Pancreatic elastase

The Gold Standard

"The gold standard" in the diagnosis and evaluation of the exocrine function of the pancreas is an indicator reflecting the state of the exocrine function of the pancreas. Pancreatic elastase is synthesized in the acinar cells of the pancreas and is produced as an inactive enzyme along with other enzymes into the duodenum 12, where it is converted into elastase under the action of trypsin. The enzyme is not affected when passing through the intestinal tract, so its content in feces is used as an indicator of the exocrine function of the pancreas. The specificity of the test in the analysis of feces is 94%, sensitivity is 93%, which makes this method an almost ideal test, the "gold standard" for diagnosing disorders of the exocrine function of the pancreas.

Clinical Manifestations

Clinical manifestations of insufficiency of the exocrine function of the pancreas include a feeling of heaviness in the abdomen after eating, bloating, various disorders of the stool (constipation, diarrhea, polyphaly — more than 1 kg), a change in the color, smell, and consistency of feces (greasy appearance, gray color, mushy, viscous), the presence of undigested food in the feces, weight loss bodies. The content of pancreatic elastase, low in newborns, reaches the level of adults by 2 weeks of age. Pancreatic elastase can enter the bloodstream in increased amounts in the case of inflammation of the pancreas (pancreatitis).

Importance of Diagnosis

The determination of elastase in feces is especially important in the diagnosis of cystic fibrosis, a hereditary disease in which the structure and functions of the cells lining the excretory ducts of the exocrine glands are disrupted, which leads to damage to the lungs, gastrointestinal tract, and digestive processes (while there is a significant decrease in the content of pancreatic elastase in feces). Only early diagnosis can prevent the fatal outcome of this disease. The determination of pancreatic elastase in stool is valuable for confirming or excluding the presence of insufficiency of exocrine pancreatic function due to chronic pancreatitis, pancreatic tumor, cholelithiasis, or diabetes (moderate decrease in concentration).

Advantages of Pancreatic Elastase Detection

The advantages of pancreatic elastase detection in feces are that pancreatic elastase is absolutely specific for the pancreas, stable during intestinal transit, the concentration in feces reflects the secretory function of the pancreas, enzyme replacement therapy does not affect its concentration, the results can be used to judge not only the level of enzyme insufficiency of the pancreas but also to assess the exocrine function in dynamics.

Preparation for the Analysis

Preparation for the analysis requires purchasing a special container with a screw cap and a spoon (to be purchased in advance in any treatment room). Feces are collected in an amount of no more than 1/3 of the container volume. The full name, date of birth, date and time of collection of the material must be indicated on the container, the entry must be made in legible handwriting. The material must be delivered to the laboratory on the day of collection. During the collection, avoid impurities of urine, secreted by the genitals. The material should be stored in a refrigerator at +4...+8°C until shipment. Download the leaflet on preparation for the analysis “Determination of pancreatic elastase” here.