Faecal elastase

Question

Hello,
Whereas previously the fecal elastase of my 3yr old daughter was normal (greater than 200), the last test shows a significant drop of elastase with a level of 57 like a severe pancreatic insufficiency. Is this result irreversible? Could the elastase return normal? is Creon enough to correct this insufficiency?

Answer

Hello,
The faecal elastase is a pancreatic enzyme which can be measured in a stool sample. A fecal elastase greater than 200 μg/g of stool reflects a normal pancreatic function, while a result below 100 μg/g indicates an exocrine pancreatic insufficiency. The fecal elastase has a good sensitivity except if there is severe diarrhea which can affect the result. If it's the case with your child, a control of faecal elastase outside the episode of diarrheoa will confirm or not the diagnosis of exocrine pancreatic insufficiency. Concerning the young children, the faecal elastase may initially be normal at the time of diagnosis and decline during the subsequent years, evolving towards pancreatic insufficiency. When pancreatic insufficiency is confirmed, it is irreversible, and therefore it requires replacement therapy by pancreatic enzymes, to allow fat digestion. This treatment corrects pancreatic insufficiency, sometimes after an adjustment period : the initial dose will be adjusted depending on the child's weight, aspect of stools, etc. ... Treatment management and adaptation according to the meals may require therapeutic education. Finally, vitamin supplements are prescribed to correct the consequences of exocrine pancreatic insufficiency on the absorption of fat soluble vitamins. The management of pancreatic insufficiency, associated with dietary management, must allow the maintenance of an optimal nutritional status.
Sincerely
Dr. Michele Gérardin

24.04.2012