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

Stool Elastase

The stool elastase test measures digestive enzyme levels to help diagnose exocrine pancreatic insufficiency (EPI).

What is a stool elastase test?

This test measures the amount of elastase in your stool. Elastase is a digestive enzyme produced by the pancreas that breaks down fats, proteins, and carbohydrates. If your pancreas is functioning correctly, elastase is released into the small intestine and appears in the stool. Low levels of elastase indicate exocrine pancreatic insufficiency (EPI), meaning the pancreas is not producing or releasing enough digestive juices, leading to malabsorption and malnutrition.

What is it used for?

The test is used to investigate the cause of unexplained digestive symptoms or to monitor pancreatic function in patients with conditions like cystic fibrosis, diabetes, or chronic pancreatitis.

Why do I need a stool elastase test?

Your provider may order this test if you experience symptoms of EPI, such as:

  • Greasy, foul-smelling stools
  • Abdominal pain, bloating, or gas
  • Unexplained weight loss
  • Malnutrition or delayed growth in children

What happens during the test?

You will need to provide a formed stool sample in a container provided by your clinic. It is critical that the sample does not mix with urine, toilet paper, or toilet water. Follow your provider's specific instructions regarding labeling, storage (refrigeration or freezing), and delivery of the sample.

Preparation and Risks

You may be asked to stop taking pancreatic enzyme supplements for five days prior to the test. Do not discontinue any medication without consulting your provider. There are no known risks associated with this test.

What do the results mean?

  • Normal amount: Suggests you likely do not have EPI, though it does not rule it out completely. Further testing may be required if symptoms persist.
  • Less than normal amount: May indicate EPI. Your provider will likely order follow-up tests to confirm the diagnosis and identify the underlying cause.

Additional Information

If you are diagnosed with EPI, treatment typically involves pancreatic enzyme replacement therapy (PERT), vitamin supplementation, and dietary adjustments, such as eating frequent small meals with healthy fats. Your provider may refer you to a dietician for personalized nutritional support.

Frequently Asked Questions

Yes, most labs ask you to withhold pancreatic enzyme supplements for at least five days before providing the stool sample. Do not stop any other medications without your provider’s approval, and resume enzymes as directed after the sample is collected.
stool elastase concentration ≥ 200 µg/g stool is generally considered normal. Levels between 100‑199 µg/g suggest mild to moderate insufficiency, and < 100 µg/g indicates severe exocrine pancreatic insufficiency. If the result is low, your clinician may order additional tests (e.g., fecal fat quantification, imaging) and typically start pancreatic enzyme replacement therapy, dietary counseling, and follow‑up monitoring.
Collect a fresh, formed stool sample in the clean container provided. Avoid any contact with urine, toilet paper, or water. If the lab requires refrigeration, keep the sample in a sealed bag in the refrigerator (2‑8 °C) and deliver it within 24‑48 hours. If you cannot deliver it promptly, freeze the sample at –20 °C and bring it frozen to the lab.
Yes. Acute diarrhea, recent gastrointestinal infections, or conditions that speed intestinal transit (e.g., laxative use) can dilute elastase and falsely lower the result. High‑fat meals do not affect the measurement, but proton‑pump inhibitors and some antibiotics have been reported to cause modest variations. Always inform the lab of any recent illnesses or medication changes.
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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