Fast Five Quiz: Exocrine Pancreatic Insufficiency Presentation and Diagnosis

B.S. Anand, MD


May 04, 2020

Steatorrhea may be masked by residual endogenous lipase production or by patients avoiding fatty food that provokes gastrointestinal symptoms. As such, the absence of steatorrhea is not unusual among patients with exocrine pancreatic insufficiency.

A positive qualitative fecal fat test result or the presence of gross steatorrhea, although helpful in the differential diagnosis, is not sensitive or specific for exocrine pancreatic insufficiency.

The fecal chymotrypsin test is less sensitive than the FE-1 test for the evaluation of exocrine pancreatic insufficiency and should not be used as a diagnostic test. The FE-1 test is very sensitive and specific for detecting advanced exocrine pancreatic insufficiency, but it may not be as reliable in patients with milder disease or watery diarrhea, or in patients after pancreatic resection.

Learn more about the workup of exocrine pancreatic insufficiency.


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