Elphick, B.; Bullimore, D.; Kapur, K.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA78
Academic Journal
Introduction: An ELISA kit for measurement of Faecal Pancreatic Elastase-1 (FE1) has recently been introduced for the investigation of pancreatic insufficiency. We compared this test with the urine pancreolauryl ratio (PLR). The clinical response to pancreatic enzyme supplements is used as the standard against which they are compared. Methods: 45 patients under investigation for chronic diarrhoea were included in the study. All had urinary PLR measured as an outpatient. This has been the standard investigation for pancreatic insufficiency in our hospital to date. These patients also had a FE1 level measured. 33 patients (with either a high clinical suspicion of pancreatic insufficiency, a PLR < 20 or a FE1 < 200 µg/I) were given a trial of pancreatic supplements (Creon) at standard dose, and their clinical response assessed. A subjective improvement in diarrhoea and objective evidence of weight gain (at least 5% gain over 6 months) was required to record a positive response. Results: We found a strong correlation between FE1 level and clinical response to Creon (p = 0.013 by Χ² analysis). However, a similar analysis yielded no significant correlation between PLR and clinical response to Creon (Χ² p = 0.15). Conclusion: FE1 more accurately predicts response to pancreatic enzyme supplements than PLR. This may be due to the inaccuracy inherent in performing the urine PLR as an outpatient. We have now adopted the FE1 for assessment of pancreatic exocrine function.


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