PT  - JOURNAL ARTICLE
AU  - Mathew, Alok
AU  - Fernandes, Darren
AU  - Andreyev, H Jervoise N
TI  - What is the significance of a faecal elastase-1 level between 200 and 500μg/g?
AID  - 10.1136/flgastro-2022-102271
DP  - 2023 Sep 01
TA  - Frontline Gastroenterology
PG  - 371--376
VI  - 14
IP  - 5
4099  - http://fg.bmj.com/content/14/5/371.short
4100  - http://fg.bmj.com/content/14/5/371.full
SO  - Frontline Gastroenterol2023 Sep 01; 14
AB  - Background Pancreatic exocrine insufficiency is a cause of malabsorption. It is generally diagnosed if faecal elastase-1 (FE-1) levels are below 200 µg/g. Pancreatic function is assumed to be normal when faecal elastase levels are >500 µg/g. The significance of faecal elastase levels above 200 µg/g but less than 500 µg/g is unclear.Methods This retrospective study reports the response to treatment in patients who had an FE-1 level between 200 and 500 µg/g.Results Of these 82 patients, 28 were offered pancreatic enzyme replacement therapy (PERT). A clinical response, defined as an improvement in their initial symptoms after commencing PERT, was seen in 20 patients (71%), 7 with potentially predisposing conditions and 13 with functional diarrhoea. PERT particularly abolished or improved diarrhoea, steatorrhoea and flatulence.Conclusion Clinicians should, therefore, be aware that a trial of PERT given to patients with FE-1 levels between 200 and 500 µg/g may lead to improvement in gastrointestinal symptoms.All data relevant to the study are included in the article.