Pancreatic elastase is the digestive enzyme the pancreas produces to help digest food. Doctors can measure elastase levels by testing a stool sample. Low levels could indicate exocrine pancreatic insufficiency (EPI).

The pancreas is a gland behind the stomach. It produces elastase and other juices that help with digestion.

Low pancreatic elastase levels could mean a person has EPI. EPI can stop the body from properly digesting fats, leading to vitamin and mineral malabsorption. It can also cause gastrointestinal symptoms, such as abdominal pain and diarrhea.

This article looks at the typical pancreatic elastase range, what low and high elastase levels could mean, and how to measure and improve elastase levels.

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Doctors consider a healthy pancreatic elastase level to be above 200 micrograms per gram (mcg/g).

A doctor can determine a person’s pancreatic elastase level with a fecal elastase-1 (Fel-1) test. This involves testing a stool sample to measure how much of the pancreatic elastase-1 enzyme is present.

Pancreatic elastase levels above 200 mcg/g may indicate a person does not have exocrine pancreatic insufficiency (EPI). However, a doctor may not always rule out EPI, even in people with this elastase range.

People may require more testing to diagnose the cause if they have an expected test result and symptoms of EPI, such as:

Elastase is an enzyme the pancreas produces to help break down fats, proteins, and carbohydrates from food so the body can use them to perform various functions. Elastase travels to the small intestine from the pancreas through a small tube.

If a person has low pancreatic elastase levels in their stool, they have EPI. This means their pancreas is not producing or releasing enough elastase-1 and other digestive juices.

EPI prevents the body from properly digesting fats, which can cause the following symptoms:

EPI complications

EPI can also lead to several complications, including:

Research does not suggest a high pancreatic elastase level can cause health issues.

Researchers do not typically state any specific level of pancreatic elastase as high. Instead, they provide an open-ended range:

Healthcare professionals can determine a person’s pancreatic elastase levels using the results of a stool sample test. There are different ways to collect stool samples. A doctor will usually provide specific instructions.

A watery stool sample may not be sufficient for testing. Because of this, a healthcare professional may suggest a person perform the test in a clinical setting, where they can collect a formed stool.

Doctors will usually provide a specific container or kit to collect the sample. They may instruct the person to:

  • label the container with their name, date, and time of collection
  • wash their hands before and after collecting the sample
  • place a collection object in the toilet, which will prevent the water in the toilet bowl from contaminating the sample
  • pass stool, ensuring they do not urinate
  • ensure the stool does not mix with water, urine, or toilet paper
  • place the sample inside the container and seal it tightly
  • return the sample for testing

Laboratory technicians will measure the levels of pancreatic elastase in the sample.

If a person takes pancreatic enzyme supplements, a healthcare professional may instruct them to stop taking them 5 days before the test.

However, some healthcare professionals may not find it necessary to stop treatment with pancreatic enzyme supplements before collecting a stool sample.

A person should not stop taking medication unless a doctor advises them to.

Treatment for EPI typically involves pancreatic enzyme replacement therapy (PERT) and lifestyle changes.

PERT involves taking supplements that contain pancreatic enzymes at mealtimes. This helps increase levels of pancreatic elastase so the small intestine can digest food properly.

Lifestyle changes and choices that may help improve pancreatic elastase levels include the following:

  • limiting or avoiding alcohol
  • quitting or avoiding smoking
  • taking vitamins if a doctor recommends it
  • frequently eating small meals that contain healthy fats

Anyone with symptoms of EPI should contact a doctor for a diagnosis and to rule out serious conditions.

People with conditions that may cause EPI, such as pancreatitis and cystic fibrosis, may also want to contact a doctor for a fecal elastase test.

Low levels of pancreatic elastase may lead to serious health complications. Prompt treatment can help prevent severe complications and improve EPI symptoms.

Pancreatic elastase is an enzyme the pancreas produces and releases into the small intestine. The enzyme helps digest food so the body can use it to perform various important functions.

Doctors can test a person’s pancreatic elastase levels by measuring the presence of the enzyme in a stool sample. Low levels of pancreatic elastase could indicate exocrine pancreatic insufficiency (EPI).

Treatment with pancreatic enzyme replacement therapy and lifestyle changes can improve a person’s pancreatic elastase levels.