Noninvasive testing options
to optimize compliance

Diagnosis and monitoring of exocrine pancreatic insufficiency

Stool testing is a critical component of diagnosing exocrine pancreatic insufficiency (EPI), and Mayo Clinic Laboratories offers multiple tests to help clinicians in their evaluation of these patients.

A 48- or 72-hour stool fecal fat test is useful for determining the presence of steatorrhea, which indicates malabsorption disorders like EPI. However, patients often find this process cumbersome and difficult to tolerate, which greatly impacts compliance.

To address this issue, Mayo Clinic Laboratories also offers pancreatic elastase testing (frequently called fecal elastase), an alternative approach to fecal fat testing that only requires a single stool collection.

Pancreatic elastase testing measures the level of the elastase enzyme within stool, enabling clinicians to identify if it is at the appropriate level for patients to digest and maintain adequate function of their pancreas.

Pancreatic elastase testing can be extremely useful for:

  • Diagnosis of exocrine pancreatic insufficiency in case of unexplained diarrhea, constipation, steatorrhea, flatulence, weight loss, upper abdominal pain, and food intolerances.
  • Monitoring of exocrine pancreatic function in cystic fibrosis, diabetes mellitus, or chronic pancreatitis.

Which test should I order?


A Test in Focus

Puanani Hopson, D.O., a Mayo Clinic pediatric gastroenterologist, explains the pancreatic elastase test — a screening test that can be useful when symptoms point to the possibility of exocrine pancreatic insufficiency. Dr. Hopson reviews when this test should be ordered, how it compares to other test options, and how its results can guide further evaluation.

Genetic testing to confirm a suspected clinical diagnosis of familial or 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. 

Genetic testing can confirm suspected clinical diagnosis of familial or hereditary pancreatitis in patients with chronic pancreatitis; identify gene mutations contributing to pancreatitis in an individual family; and allow for predictive and diagnostic testing in family members.

Learn more about how to order these evaluations at your institution.