Fecal elastase
Pancreatic digestive enzyme measured in stool as an indicator of the pancreas's digestive function
Also known as
Definition
Elastase is one of the digestive enzymes that the pancreas makes and releases through its duct into the small intestine. The enzyme is measured in stool. Little or no elastase can indicate that the pancreas does not make or release enough digestive juices (exocrine pancreatic insufficiency). According to the German S3 guideline on pancreatitis, measuring fecal elastase is the most widely used method in Germany for testing this function.
| Parameter | Value |
|---|---|
| Unit | µg/g stool |
| Reference Range | Typically above 200 µg/g stool in adults. Labs differ from one another; the range printed on your report is what counts, and your doctor interprets the result. |
Agree on your personal target range with your doctor.
↓ What a low value means
A low value can indicate that the pancreas makes or releases too few digestive enzymes (exocrine pancreatic insufficiency). Abnormal results are often described as moderate or severe; very low values are usually found with marked insufficiency. In adults, the main possible cause is chronic pancreatitis; others include acute pancreatitis, cystic fibrosis, diabetes, Crohn's disease, ulcerative colitis, pancreatic cancer or surgery on the digestive tract. Further tests are usually needed to confirm the finding and find the cause; discuss the result with your doctor.
↑ What a high value means
A value above 200 µg/g is considered normal. According to the S3 guideline, a value above 500 µg/g rules out exocrine pancreatic insufficiency. A normal value below that, however, does not reliably rule out mild to moderate insufficiency, because the test detects severe forms better than mild ones. If symptoms persist despite a normal result, further tests may be useful; your doctor decides.
When to test
With digestive symptoms of unknown cause, such as greasy, foul-smelling stools, abdominal pain, bloating or unintended weight loss, and to monitor chronic pancreatitis, cystic fibrosis or diabetes. The stool sample should be formed, not watery, and must not mix with urine or toilet water. If you take pancreatic enzymes, your practice may give instructions for the time before the test; do not stop anything on your own.
Frequently asked questions
How is the sample collected? +
You hand in a stool sample in a container from the lab or practice. The sample should be formed and must not come into contact with urine, toilet paper or toilet water. Follow the storage instructions and return the sample promptly.
Does a normal value rule out a functional disorder? +
Not always. The test detects severe forms of exocrine pancreatic insufficiency better than mild or moderate ones. According to the S3 guideline, only a value above 500 µg/g counts as ruling it out. If symptoms persist, further tests may be needed.
Can the test show whether enzyme therapy is working? +
No. According to the S3 guideline, the test measures only the body's own human elastase, not enzymes taken as medicine. Your doctor assesses whether enzyme therapy is working with other methods.
How does it differ from lipase and amylase in the blood? +
Lipase and amylase in the blood are mainly measured when inflammation of the pancreas is suspected. Fecal elastase, by contrast, is used to check the digestive function of the pancreas, that is, whether enough enzymes reach the gut.
Fecal elastase
Sources
Last updated: October 05, 2026
This information is for orientation only and does not replace medical advice. Reference ranges can vary by laboratory, method and country.