Fecal Elastase-1 (FE-1)

What is Faecal Elastase-1 (FE-1)?

Table of Contents

Faecal Elastase-1 (FE-1) is a test that measures the level of pancreatic elastase-1 in stool. It is used to assess the exocrine function of the pancreas — its ability to produce and secrete digestive enzymes — and can help screen for exocrine pancreatic insufficiency (EPI), a condition in which the pancreas does not produce or release sufficient digestive enzymes.

The Pancreas

The pancreas produces several enzymes that help digest food, including lipase, amylase and proteases.

Elastase is relatively stable as it passes through the digestive tract, making it suitable for measurement in stool. The level of fecal elastase-1 can therefore be used as an indicator of pancreatic enzyme secretion.

Interpretation of Results

  • ≥200 µg/g stool: Normal
  • 100–199 µg/g: Reduced or requires further assessment
  • <100 µg/g: Strongly supports the possibility of exocrine pancreatic insufficiency (EPI)

Important Note

The reference ranges and interpretation should follow the testing method and reference criteria used by the individual laboratory.

Very watery or liquid stool samples may also result in a falsely low fecal elastase-1 measurement due to dilution.

Faecal Elastase-1 in the Gut Dysfunction Panel

For the Gut Dysfunction Panel, Faecal Elastase-1 can be included under:

Digestion & Absorption

This helps assess pancreatic digestive function, particularly whether the pancreas is producing sufficient digestive enzymes to support normal digestion.

Summary

Faecal Elastase-1 helps assess whether the pancreas is producing sufficient digestive enzymes for normal digestion.

References

  1. Dominici, R., & Franzini, C. (2002). Fecal elastase-1 as a test for pancreatic function: A review. Clinical Chemistry and Laboratory Medicine, 40(4), 325–332.
  2. Whitcomb, D. C., Buchner, A. M., & Forsmark, C. E. (2023). AGA clinical practice update on the epidemiology, evaluation, and management of exocrine pancreatic insufficiency: Expert review. Gastroenterology, 165(5), 1292–1301.

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