Which is the diagnostic test in pancreatic steatorrhea?
High-Yield Explanation
The fecal elastase-1 and small bowel biopsy are useful in the evaluation of patients with suspected pancreatic steatorrhea. A decrease of fecal elastase level to <100 mg per gram of stool strongly suggests severe pancreatic exocrine insufficiency. The diagnostic test with the best sensitivity and specificity in chronic pancreatitis is the hormone stimulation test utilizing secretin. It becomes abnormal when > 60% of the pancreatic exocrine function has been lost. In contrast to acute pancreatitis, the serum amylase and lipase levels are usually not strikingly elevated in chronic pancreatitis.