Pancreatic Elastase 1 Test

Pancreatic elastase 1 is a digestive enzyme made by your pancreas, the same organ that produces insulin. Its main job is to help break down proteins in your food. When you eat, your pancreas releases pancreatic elastase, along with lipase (for fats) and amylase (for carbohydrates), into your small intestine. Unlike most other digestive enzymes, elastase stays stable as it passes through your gut, which means it can be measured accurately in a stool sample.

Because of this stability, stool pancreatic elastase (often called fecal elastase-1) has become one of the best noninvasive ways to measure exocrine pancreatic function, the part of the pancreas responsible for producing digestive enzymes (as opposed to the endocrine function, which produces hormones like insulin).

Healthy levels indicate your pancreas is making enough enzymes to digest and absorb nutrients efficiently. Low levels can signal exocrine pancreatic insufficiency (EPI), a condition where the pancreas doesn’t produce enough enzymes to properly digest food. When that happens, fats, proteins, and carbohydrates pass through the gut only partially digested, leading to symptoms like bloating, gas, greasy or floating stools, and unintended weight loss. Over time, poor digestion can cause nutritional deficiencies, especially of fat-soluble vitamins (A, D, E, and K), vitamin B12, and iron.

In milder or early cases, symptoms can be subtle, e.g. fatigue, difficulty maintaining muscle mass, or unexplained weight changes, even with a seemingly healthy diet. This makes pancreatic elastase a valuable early signal of pancreatic stress before more serious damage or deficiency occurs.

Low or borderline pancreatic elastase levels can result from several factors, including chronic pancreatitis (long-term inflammation of the pancreas), gallbladder or bile issues, heavy alcohol use, diabetes, or celiac disease. Certain medications can also contribute. Your clinician may recommend additional testing, digestive enzyme support, or dietary adjustments such as moderating fat intake, emphasizing whole foods, and eating slowly in a relaxed state to optimize enzyme release.