Elastase Testing Information for Patients

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Elastase Testing Information for Patients

What is an Elastase Test?

The elastase test checks how well your pancreas is working. Your pancreas is a small but important organ that helps break down food. It produces digestive enzymes, one of which is called elastase.

Elastase passes through your gut and ends up in your poo (stool). By measuring how much elastase is in your stool, doctors can get a good idea of how well your pancreas is working. If the level is low, it could mean your pancreas isn’t making enough digestive enzymes.

This test can help identify a condition called pancreatic insufficiency.

What is Pancreatic Insufficiency?

Your pancreas plays a key role in digestion. It produces enzymes that break down fats, proteins, and carbohydrates in the food you eat. These enzymes are released into your gut, where they help unlock nutrients so they can be absorbed into your bloodstream.

Pancreatic insufficiency means your pancreas isn’t making or releasing enough of these enzymes. This makes it harder for your body to digest food properly. The level of insufficiency can vary from person to person, and so can the symptoms.

Common symptoms include:

Abdominal pain
Weight loss
Diarrhoea
Smelly or loose stools
Bloating and gas
Loss of appetite
Tiredness or fatigue

These symptoms can be mild or severe and often get confused with other digestive problems which is why stool test like the elastase test is so useful.

What Causes Pancreatic Insufficiency?

Pancreatic insufficiency is usually the result of an underlying condition.

Some of the most common causes include:

Chronic pancreatitis
Cystic fibrosis
Diabetes
Crohn’s disease
Pancreatic cancer
Ageing
Certain lifestyle factors (like heavy alcohol use)

While pancreatic insufficiency is a symptom rather than a disease itself, diagnosing it helps your doctor figure out the next steps.

What Does the Elastase Test Tell You?

The test measures how much pancreatic elastase is present in your stool. This number helps indicate how well your pancreas is producing enzymes.

Here’s what the results mean using the BÜHLMANN fPELA® turbo test:

Elastase Level (µg/g)	What it means:
200 to >500 µg/g	Normal pancreatic function
100 to 200 µg/g	Intermediate result – your doctor may ask you to repeat the test
Less than 200 µg/g	Suggests pancreatic insufficiency

A low or borderline result doesn’t confirm the cause, but it shows your pancreas may not be working as it should. Your doctor will look at your symptoms and may do further tests to get a full picture.

Why is this Test Useful?

This test is non-invasive, easy to do at home, and gives valuable information. If the result shows your pancreas isn’t working well, your doctor may recommend treatments such as pancreatic enzyme replacement therapy (PERT). This can help improve your digestion, reduce symptoms, and boost your overall quality of life.

As with all faecal elastase assays it is recommended not to test using liquid samples because the additional fluid will dilute out the elastase giving a falsely low result.

How to Complete an Elastase Test using a CALEX Device

Your Healthcare Provider may have given you a Faecal Elastase Collection Kit, with a CALEX device, rather than a traditional collection container.

Each kit comes discreetly packaged and includes:

A CALEX extraction device to collect your sample
Instructions with clear steps on how to use the kit
A grip-seal bag to return the CALEX and request form

The instructions are written in simple terms and include helpful diagrams. If you require large font format instructions for use, or a narrated video alternative, visit this page.

View Instructions for Use

Guidelines:

Pancreatic insufficiency is a consequence of several chronic conditions, and so the testing of faecal pancreatic elastase is in the recommendations for many patient pathways including:

BSG guidelines for screening of patients presenting with chronic diarrhoea or malabsorption after the initial infective, cancer and IBS/IBD routes have been investigated.
In patients with chronic pancreatitis NICE recommends that patients are monitored for insufficiency every 6 months if they are under 16 years of age otherwise every 12 months.
Studies have shown that 63% of newborn infants with cystic fibrosis have pancreatic insufficiency and a further 30% will develop the condition within 36 weeks. Overall 85% of cystic fibrosis patients will have pancreatic insufficiency requiring long term PERT treatment.
In patients with Cystic Fibrosis NICE recommends ‘testing for exocrine insufficiency using a non-invasive technique such as stool elastase estimation. If the test is normal, repeat it if symptoms or signs suggesting malabsorption occur’.
A recent publication concluded that 12% of Type 1 and 2 Diabetes patients have undiagnosed PEI which given the increasing prevalence of these conditions is an unrecognised burden of PEI and can have long term health consequences for those effected. Routine screening for PEI, using FE1 testing, should be considered for all diabetic patients. Furthermore, the finding of a low FE1 should prompt additional investigations on these patients.