The role of fecal elastase-1 in detecting exocrine pancreatic disease

Nat Rev Gastroenterol Hepatol. 2011 May 31;8(7):405-15. doi: 10.1038/nrgastro.2011.91.


Exocrine pancreatic disease is thought to be uncommon in clinical practice and usually secondary to excess alcohol intake. Although excess alcohol intake does account for many cases of exocrine pancreatic disease, other conditions are associated with exocrine pancreatic insufficiency and such dysfunction perhaps occurs more frequently than conventionally expected. A reliable, patient-friendly, cheap and easy to use test for exocrine pancreatic disease is yet to be established; however, in many countries the main (and often only available) method of assessment of exocrine pancreatic function is the fecal-elastase-1 test. This Review examines the role of fecal-elastase-1 testing in detecting exocrine pancreatic insufficiency in a number of gastrointestinal and nongastrointestinal conditions and determines the value of pancreatic enzyme supplementation in these settings.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Exocrine Pancreatic Insufficiency / diagnosis
  • Exocrine Pancreatic Insufficiency / metabolism
  • Feces / enzymology*
  • Humans
  • Pancreas, Exocrine / physiopathology*
  • Pancreatic Diseases / diagnosis*
  • Pancreatic Diseases / metabolism
  • Pancreatic Elastase / metabolism*
  • Pancreatic Function Tests / methods


  • Biomarkers
  • Pancreatic Elastase