Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test.
The early diagnosis of pancreatic exocrine insufficiency (PEI) is hindered because many of the functional diagnostic techniques used are expensive and require specialized facilities, which prevent their widespread availability. We have reviewed current evidence in order to compare the utility of these functional diagnostic techniques with the fecal elastase-1 (FE-1) test in the following three scenarios: screening for PEI in patients presenting with symptoms suggestive of pancreatic disease, such as abdominal pain or diarrhea; determining the presence of PEI in patients with an established diagnosis of pancreatic disease, such as chronic pancreatitis or cystic fibrosis; determining exocrine status in disorders not commonly tested for PEI, but which have a known association with this disorder. Evidence suggests the FE-1 test is reliable for the evaluation of pancreatic function in many pancreatic and non-pancreatic disorders. It is non-invasive, is less time-consuming, and is unaffected by pancreatic enzyme replacement therapy. Although it cannot be considered the gold-standard method for the functional diagnosis of PEI, the advantages of the FE-1 test make it a very appropriate test for screening patients who may be at risk of this disorder.
Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, C/Choupana s/n, 15706, Santiago de Compostela, Spain. enriquedominguezmunoz@hotmail.com.
J Enrique
JE
Domínguez-Muñoz
Medical Department V, University Hospital, Giessen, Germany.
Philip
P
D Hardt
Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
Markus M
MM
Lerch
Department of Digestive Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Matthias J
MJ
Löhr
D003550:Cystic Fibrosis / Q000150:complications; D010188:Exocrine Pancreatic Insufficiency / Q000150:complications / Q000175:diagnosis*; D005243:Feces / Q000201:enzymology*; D006801:Humans; D010196:Pancreatic Elastase / Q000737:chemistry / Q000378:metabolism*; D050500:Pancreatitis, Chronic / Q000150:complications
D010196:Pancreatic Elastase
Chronic pancreatitis; Diabetes mellitus; Fecal elastase-1; Malnutrition; Pancreatic exocrine insufficiency