Faecal Pancreatic Elastase 1 - A Useful Non Invasive Measure of Exocrine Pancreatic Function

Abstract

The major objective of this work was to establish the assay of faecal elastase I in spot stool samples as an exocrine pancreatic function test for the Korle-Bu teaching hospital. The assay of faecal elastase I was carried out in spot stool samples from apparently healthy persons and subjects with various pancreatic and non pancreatic diseases. The resultobtained confirmed the diagnostic efficiency of pancreatic elastase 1 determination in stool as a standard testof exocrine pancreatic function. The results of the faecal elastase 1 test were able to characterise the degree of severity of exocrine pancreatic insufficiency into, (1 ) the mild to moderate group with elastase concentration between 100 and 200 (μg/g stool and ( 2 ) the severe pancreatic insufficiency group with elastase concentration of <100μg/g stool. Elastase I activity in spot stool samples from apparently healthy group ranged from 165 to 870(μg/g with a (mean ± SEM) of 379 ± 41μg/g, the enzyme activity in patients with various gastroduodenal diseases but non pancreatic in origin ranged from 85 to 1171 μg/g, with a (mean ± SEM) of 479 ± 41μg and the range of 20-285 μg/g with a (mean ± SEM) of 112.9 ± 11.6 μg/g in the pancreatic disease group. The pancreatic elastase 1 was found to be stable in faeces for several weeks when stored frozen and offer the possibility of saving cost to the patient when determinations are done in batches. The results show that the determination of faecal pancreatic elastase 1 concentration in spot stool samples of patients with epigastric pain provides a reliable differential diagnosis of exocrine pancreatic insufficiency.