Digestion & Absorption: Pancreatic Elastase 1 (PE-1)

Written by and republished with permission from Genova Diagnostics


PE-1 is a proteolytic enzyme exclusively secreted by the pancreas. Analyzing fecal PE-1 is a useful, non-invasive way of evaluating pancreatic exocrine function and identifying exocrine pancreatic insufficiency (EPI). Low values of PE-1 indicate EPI, which is associated with a variety of gastrointestinal symptoms and illnesses.

What are the clinical indications for evaluating PE-1?

Patients for whom PE1 testing may be useful include those with:

  • Unexplained diarrhea, including diarrhea-predominant Irritable Bowel Syndrome (IBS)
  • Weight loss
  • Maldigestion (Steatorrhea)
  • Abdominal pain, including symptoms meeting clinical criteria for IBS
  • Low bone density

In addition, EPI may occur secondary to:

  • Chronic Pancreatitis, including that associated with excessive alcohol consumption
  • Inflammatory Bowel Disease (Crohn’s disease)
  • Diabetes
  • Celiac Disease
  • Cystic Fibrosis
  • GI and pancreatic procedures


What are the benefits of evaluating PE-1 through stool?

  • PE-1 is a marker of exocrine pancreatic function. The gold-standard test, secretin-pancreozymin, is an invasive method of evaluating PE-1. In contrast, PE-1 assessment through a Genova Diagnostics stool test, such as GI Effects®, offers a non-invasive method of evaluation.
  • PE-1 is not degraded during intestinal transit and is unaffected by increases or decreases in transit time.
  • Genova’s GI Effects® Comprehensive Stool Profile performs a monoclonal PE-1 assessment that is not affected by pancreatic enzyme replacement therapy (PERT), which allows patients to begin or maintain treatment regimens while being tested.


What are the clinical indications of an abnormal result?

Results that indicate pancreatic exocrine insufficiency warrant further investigation to determine the “root cause” of the dysfunction. Pancreatic enzyme replacement therapy (PERT), based on the level of insufficiency identified, is used to support patients with EPI. In reporting results, levels of exocrine pancreatic function are classified as follows:

  • Normal exocrine pancreatic function: PE-1 values of >200μ/g to <500μ/g
  • Moderate-to-mild exocrine pancreatic insufficiency: PE-1 values between 100 μ/g to 200 μ/g
  • Severe exocrine pancreatic insufficiency: PE-1 values <100 μ/g


The original blog and more information can be found here.

Learn more about Genova’s GI Effects test.
Read Genova’s GI Effects Comprehensive Support Guide PDF.


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