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Chymotrypsin in Stool
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Lab Tests

Chymotrypsin in Stool

This test measures the amount of the enzyme chymotrypsin in your stool to help identify pancreatic insufficiency.

What is a chymotrypsin in stool test?

This test measures the amount of chymotrypsin in a stool sample. Chymotrypsin is an enzyme released by your pancreas to help break down protein during digestion. If your pancreas releases lower-than-normal amounts of this enzyme, you may have exocrine pancreatic insufficiency (EPI), meaning you cannot digest food properly.

Pancreatic insufficiency is often caused by chronic pancreatitis or cystic fibrosis (CF). Your stool may also be tested for trypsin, another digestive enzyme released by the pancreas.

What is it used for?

The test is used to check for pancreatic insufficiency and to help diagnose conditions like pancreatitis and cystic fibrosis. It also helps determine the cause of malnutrition, where the body fails to absorb necessary calories, vitamins, and minerals.

Why do I need a chymotrypsin in stool test?

You may need this test if you experience symptoms of pancreatic insufficiency, such as:

  • Chronic diarrhea
  • Abdominal pain
  • Bloating and gas
  • Loose, foul-smelling, greasy stools
  • Weight loss

What happens during a chymotrypsin in stool test?

You will need to provide a fresh sample of loose or liquid stool. Follow your provider's instructions carefully regarding collection, which typically involves using a clean container or special paper/plastic wrap to catch the stool without mixing it with urine, toilet paper, or toilet water. If you cannot return the sample immediately, it should be refrigerated.

What do the results mean?

  • Positive result: Shows a normal amount of chymotrypsin (and trypsin, if tested).
  • Negative result: The amount of chymotrypsin or trypsin is below normal, which may indicate pancreatic insufficiency.

A negative result does not diagnose a specific disorder on its own. Your provider may order further tests, such as a stool elastase test or blood tests for lipase and amylase, to investigate further.

Frequently Asked Questions

Yes. Proton‑pump inhibitors, H2 blockers, and pancreatic enzyme replacement therapy (e.g., pancrelipase) can lower measured chymotrypsin levels, leading to a false‑negative result. Antacids that alter gastric pH may also affect enzyme activity. Inform your provider about all current meds; they may ask you to hold certain drugs for a short period before collection.
Both are non‑invasive screens, but fecal elastase‑1 is generally considered more sensitive for mild to moderate pancreatic insufficiency because elastase is more stable in stool. Chymotrypsin can be degraded by bacterial proteases, leading to occasional false‑low results. In practice, many clinicians start with fecal elastase; chymotrypsin may be used when elastase is unavailable or as a confirmatory test.
negative result suggests exocrine pancreatic insufficiency. Your clinician will likely order additional tests such as fecal elastase‑1, a secretin‑stimulated MRCP, or a direct pancreatic function test (e.g., secretin‑cholecystokinin stimulation). Imaging (CT or MRI) may be performed to look for structural disease, and a trial of pancreatic enzyme replacement can be used diagnostically—symptom improvement supports insufficiency.
Collect a fresh, loose or liquid stool sample using the clean container supplied by the lab. Avoid mixing stool with urine, toilet paper, or water. If the sample cannot be delivered within 2 hours, refrigerate it (2‑8 °C) and bring it to the lab within 24 hours. Do not freeze unless the lab specifically instructs you.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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