Mayo Clinic Laboratories > Gastroenterology > Malabsorption > Exocrine pancreatic insufficiency

Exocrine pancreatic insufficiency

Noninvasive testing options to diagnose and monitor

Exocrine pancreatic insufficiency (EPI), which is characterized by a lack of exocrine pancreatic enzymes and results in an inability to properly digest food, has both genetic and idiopathic causes. Our full suite of EPI testing includes traditional 48- and 72-hour fecal fat evaluations for steatorrhea, which is indicative of EPI; less-invasive pancreatic elastase testing, which requires just one stool sample; and genetic testing to confirm hereditary pancreatitis, which can involve EPI.

Exocrine pancreatic insufficiency Test menu

Pancreatic elastase testing

Many patients find the stool collection process for fecal fat testing cumbersome and difficult to tolerate, which can impact compliance. To help make this process easier for patients, we offer pancreatic elastase testing (frequently called fecal elastase) that requires only a single stool collection to measure the level of the elastase enzyme within stool.

Key testing


  • Measures levels of the elastase enzyme to evaluate appropriateness for digestion and maintaining adequate pancreatic function.
  • Facilitates diagnosis of EPI in cases of unexplained diagnosis, constipation, steatorrhea, flatulence, weight loss, upper abdominal pain, and food intolerances.
  • Assists in monitoring EPI patients with cystic fibrosis, diabetes mellitus, or chronic pancreatitis.


Genetic testing for hereditary pancreatitis

Hereditary pancreatitis (HP) is defined as two or more individuals in a family affected with pancreatitis involving at least two generations. Mutations in several genes, including PRSS1, CFTR, CTRC, and SPINK1, have demonstrated genetic susceptibility to chronic pancreatitis.

Key testing


  • Confirms suspected clinical diagnosis of familial or hereditary pancreatitis in patients with chronic pancreatitis.
  • Identifies gene mutations contributing to pancreatitis in an individual family.
  • Allows for predictive and diagnostic testing in family members.

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