pancreatic elastase test results >500

Available online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3848141/. When you consume PERT with food, it duplicates the normal digestive process because the enzymes mix with the food and help you absorb more nutrition from the food and supplements that you consume. Fecal pancreatic elastase is a non-invasive marker of exocrine pancreatic function. They have also diagnosed me with a mild bile malabsorption issue. Less common etiologies of exocrine pancreatic insufficiency. Fecal pancreatic elastase 1 (FPE1) assay (ScheBo Tech) has been proposed as a reliable test to evaluate pancreatic exocrine function, with sensitivities of up to 100% in diagnosing CP. Maybe this is an oversight on the part of the consultant? . The normal reference range is between 100-500ug/g. Do you have IBS?? Pancreatitis suspected amylase levels are > 200 U/L and lipase levels are > 200 U/L. If specimen is sent refrigerate, send immediately after collection. For these, please consult a doctor (virtually or in person). Chronic Pancreatitis. Immundiagnostik AG; 2019). Had ulq pains 7months. Eat multiple, small meals spaced throughout the day, rather than one or two large meals. All SCP had values of < 100 micrograms/g but more than half of the MCP subjects had FPE1 levels within the normal range. Conwell DL, Lee LS, Yadav D, Longnecker DS, Miller FH, Mortele KJ, Levy MJ, Kwon R, Lieb JG, Stevens T, Toskes PP, Gardner TB, Gelrud A, Wu BU, Forsmark CE, Vege SS. He is a specialist at Cedars Sinai in LA and does extensive research/treatment of the pancreas. Struyvenberg, M. et. By using our website, you consent to our use of cookies. The exocrine pancreas is responsible for producing elastase along with other enzymes that are transported to the small intestine to break down fats, proteins, and carbohydrates as part of food digestion. PMC 24 No 1: 117-123. Call the lab for their instructions, An elastase test may be ordered when a person has signs and symptoms of pancreatic insufficiency, such as: A normal amount of elastase will be present in the stool of healthy individuals. World J Gastroenterol. Making a diagnosis of PEI requires more than a single abnormal Fel-1 level and includes assessment of the patients symptoms, nutritional status, risk factors for pancreatic disease, endocrine function and structural imaging. Exocrine pancreatic insufficiency (EPI) is described as a reduction in pancreatic enzyme activity below the normal digestive threshold level. This test measures the amount of elastase in your stool. Accessed on 3/19/17. I think I also recall them saying that above 200ug was normal and that they were more concerned with the lower numbers as the lower the numbers there was a chance of pancreatic insufficiency! "The pancreas produces many enzymes. Chen C, Xie Z, Shen Y, Xia S.F. These values do not apply to results that are converted to other units of measure. 2001 Oct;36(10):1092-9. Accessibility I had a look at the links but cant seem to see anything about Elastase levels being too high. Goldin E, Wengrower D. Diarrhea in hypothyroidism: bacterial overgrowth as a possible etiology. Schneider, A. et. Cutoff values (microgram/g stool) of < 100 have been suggested as SCP, 100-200 as MCP, and > 200 as normal. 2014 Nov;43(8):1143-62. doi: 10.1097/MPA.0000000000000237. Some symptoms include: fever fatty stools nausea with or without vomiting intense pain in the upper. National Institute of Diabetes and Digestive and Kidney Diseases: Pancreatitis, In children, an inability to gain weight, delayed growth. All Rights Reserved. Romanian Guidelines on the Diagnosis and Treatment of Exocrine Pancreatic Insufficiency. Formal Name: Fecal Elastase-1. Pancreatic elastase concentrations above 200 mcg/g are normal and are not indicative of exocrine pancreatic insufficiency. Chew food thoroughly and relax at meal time (this helps get digestive juices flowing and working early on through your saliva). In a healthy pancreas, elastase will be passed in the stool. Accessed on 3/19/17. The enzyme stability is remarkably high despite its proteolytic activity, as elastase is found in feces in about a sixfold concentration as in pancreatic fluid. Elastase (Pancreatic Elastase 1), S. 14048-3. Sparkle44- here are some good resources from Mission: Cure that you'll probably find helpful. 3/3/2014: Update reference range for Normal (previously 200 to >500) 6/19/2018: Updated units and specimen processing 8/4/2020: Moved from forward to Joli to internal test at Mayo. Please use an alternative web browser, or listen from your mobile device on a preferred listening app. Generally, a level of at least 200 micrograms per gram (mcg/g) is considered normal. Clinics (Sao Paulo). 2023 HealthCheckUp.com. In-depth research on any test at your fingertips, all stored and tracked in one place. Over time, chronic inflammation can damage the pancreatic cells that make digestive enzymes. Because the sensitivity of elastase-1 stool testing is lower for mild to moderate EPI, falsely normal results may be obtained more often for people with mild or moderate EPI. Save time on interpreting lab results with the largest database of biomarkers online. The pancreas is part of your digestive system. National Library of Medicine Elastase is an enzyme produced by special tissue in the pancreas, an organ in the upper abdomen. Nat Rev Gastroenterol Hepatol. I hope these are helpful- good luck! Fatty foods can worsen steatorrhea, but it is still important to consume enough fat for necessary bodily functions and because fats are required to absorb certain vitamins. Lhr, J. et. Elastase is an enzyme produced by special tissue in the pancreas, an organ in the upper abdomen. Your gastroenterologist will use this as part of your overall evaluation. EPI occurs when your pancreas doesnt make enough digestive enzymes. Sorry to be a pain, but anything on high levels of elastase and the impact would be great. 1. Fecal elastase-1 determination: gold standard of indirect pancreatic function tests? Underweight individuals will need to focus on high-calorie foods, to get enough energy for optimal health. Elastase is one of them that's really important because it doesn't get degraded by bacteria, which means we can test it easily in stool," Dr. Hopson says. 2023 TESTING.COM. 10 year old daughter failure to thrive on high caloric diet 136 pancreatic elastase sweat test negative what else could be wrong to cause this? If a condition prevents the intestines from absorbing nutrients, then they are lost by elimination in the stool. A dose response curve of absorbance unit (optical density at 450 nm) vs. concentration is generated using the values obtained from the standards. Logistics Test Indications: . American Pancreatic Association Practice Guidelines in Chronic Pancreatitis: evidence-based report on diagnostic guidelines. Unable to load your collection due to an error, Unable to load your delegates due to an error. Accessed on 3/19/17. Lyon, E. et. A fecal elastase-1 test measures the amount of elastase in your stool. Children with cystic fibrosis and adults with chronic pancreatitis are most likely to have EPI. The values of pancreas function test include normal amylase levels of 23-85 U/L (some lab results go up to 140 U/L) and lipase levels of 0-160 U/L. CPT codes and LOINC update: February 2023, Whole genome sequencing streamlines diagnosis. Pancreatic enzyme replacement therapy (PERT) can help. Elastase helps break down fats, proteins, and carbohydrates after you eat. *Normal exocrine pancreatic sufficiency: 200 to >500 ug E1/g stool, *Moderate to mild exocrine pancreatic insufficiency: 100 200 ug E1/g stool. The pancreas is an organ located in the abdomen that consists of two kinds of tissues: exocrine and endocrine. World J Gastroenterol. Monoclonal versus Polyclonal ELISA for Assessment of Fecal Elastase Concentration: Pitfalls of a New Assay. To help detect and evaluate pancreatic insufficiency, When you have signs and symptoms such as stomach cramps, weight loss, malnutrition, malabsorption, delayed growth (in children) and fatty, foul-smelling stools and pancreatic insufficiency is suspected, A fresh formed stool sample that is not contaminated with urine. https://www.medicalnewstoday.com/articles/310292.php Updated July 23, 2018. I cant seem to find anything online that is helpful. This condition is called exocrine pancreatic insufficiency. Available online at https://emedicine.medscape.com/article/2121028-overview Accessed on 3/19/17. Waldum HL, Kleveland PM, Srdal F. How Do Adaptogenic Herbs Benefit Hashimotos? Our technology helps to understand, combine, track, organize, and act on your medical lab test results. PMID: 33489070; PMCID: PMC7802491. notes indicate:it is not necessary to interrupt enzyme substitution thearpy Dr. Shaban Faruqui answered Specializes in Gastroenterology Keeping a close eye on symptoms can help identify possible EPI so you can treat it right away. This leads to uncomfortable digestive problems, such as: Many digestive problems cause symptoms similar to EPI. Although the assay detected SCP with steatorrhea, it did not consistently separate the MCP patients from normals. Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Interpret your laboratory results instantly with us. 200 - 1000 mcg/g. Hi Sparkle44- A high fecal elastase test is a strong indicator of exocrine pancreatic insufficiency (EPI) meaning your pancreas isnt producing enough enzymes to digest and absorb food properly. People with EPI dont have enough pancreatic (digestive) enzymes to break down foods and absorb nutrients. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Pancreatic Elastase is an enzyme produced by exocrine tissue in the pancreas. Title: Pancreatic Elastase, Stool Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Bethesda, MD 20894, Web Policies Your healthcare provider may suspect EPI if you have a condition that affects your pancreas. Pancreatic elastase concentrations below 100 mcg/g are consistent with exocrine pancreatic insufficiency. Surgery on the digestive tract, including. It is released as a zymogen, which is then converted to an active enzyme in the duodenum by trypsin. Many people with Hashimotos have the opposite issue , Consider adding digestive herbs to the meal (note that. It's a key part of your digestive process. Hiya HealthSleuths, I didnt find anything & just totally lost sight of this in amongst all the other health issues at the time. al. Consider pepsin, plant or pancreatic enzyme supplements, digestive herbs, bile salts, and taurine. Chronic pancreatitis: A diagnostic dilemma. If specimen is sent refrigerate, send immediately after collection. Why Balancing Blood Sugar is Vital for Hashimotos Health, NAC for Thyroid Antibody Reduction, Detoxification and Gut Health, Solutions to Increase Low Libido in Those with Hashimotos. Medscape Drugs and Diseases. Available online at https://www.ncbi.nlm.nih.gov/pubmed/25360312. "The elastase test measures the level of pancreatic enzyme within the stool. If you have PEI, it is a good idea to consult with a registered dietitian, who can work with you to establish a meal plan tailored to your lifestyle, that maximizes the nutritional quality of what you eat, and reverses any nutritional deficiencies. Secretin pancreatic function test to test how the pancreas responds to secretin, a hormone that triggers the release of digestive enzymes. Pancreatic insufficiency in cystic fibrosis. (2016 December 16 Updated). Presented as part of the 2017 Institute for Functional Medicine Conference; October 2017; Denver, CO. Chowdhury P, Gupta P. Pathophysiology of alcoholic pancreatitis: an overview. At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. FE-1 is enriched 5-6 fold in the faeces compared with pancreatic juices and can be used as an indicator of pancreatic exocrine function. are my intestines functioning normally then? Any help or advice would be greatly appreciated! Separate specimens must be submitted when multiple tests are ordered. Your doctor may start you on enzymes or repeat the test for accuracy depending on your symptoms. Whats to Know About Exocrine Pancreatic Insufficiency? In-depth research on any test at your fingertips, all stored and tracked in one place. This test is an excellent biomarker for how well the pancreas is working because the enzyme pancreatic elastase I is not broken down by what happens in the intestinal tract. Your body needs these nutrients for energy and to maintain organ function. [Measurement of fecal elastase 1 by immunoreactivity: a new indirect test of the pancreatic function]. In this "Test in Focus" episode of the "Answers From the Lab" podcast, Puanani Hopson, D.O., a Mayo Clinic pediatric gastroenterologist, provides an overview of this test. Fecal elastase-1 as a test for pancreatic function: a review. However, there are options available that make it easier for the body to break down and absorb nutrients, which can help reduce the steatorrhea and nutritional deficiencies that PEI causes. Consequences of dysthyroidism on the digestive tract and viscera. , Hiya this is beautifully reassuring thanks so much for sharing x. Hiya Linda thanks so much you are a gem! Frontline Gastroenterol. The most common risk is discomfort or embarrassment related to collecting the sample. The purpose of an elastase stool test is to help diagnose pancreatic insufficiency, a condition in which the pancreas does not produce enough enzymes to properly digest food. doi: 10.1152/ajpgi.00060.2017. Upload your lab reports and get interpretation today. Contribute to chinapedia/wikipedia.en development by creating an account on GitHub. Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them. It makes enzymes that aid digestion and help your body absorb nutrients. An elastase test may be ordered when a person has signs and symptoms of pancreatic insufficiency, such as: Abdominal cramps and bloating Foul-smelling, bulky, greasy stools In children, an inability to gain weight, delayed growth Malabsorption Malnutrition Vitamin deficiencies Weight loss What does the test result mean? Interpret your laboratory results instantly with us. For the test, you receive secretin through an intravenous (IV) line. As many as 8 in 10 adults with this disorder develop EPI. Another inherited condition, Shwachman-Diamond syndrome (SDS), also causes EPI in children. Results. EPI is a lifelong condition. One is a blog post and the other is the most frequently watched webinar- both on EPI. Before In children, it is most frequently associated with cystic fibrosis (CF) or Shwachman-Diamond syndrome (SDS). Background People with pancreatic dysfunction often need to be monitored closely by their healthcare practitioner. This website uses cookies to ensure you get the best experience on our website. 1996;20(5):424-9. https://www.abingtonhealth.org/healthy-living/health-news/library/articles-related-to-pregnancy-and-breastfeeding/a-guide-to-gallstones-during-pregnancy/. Lower levels may indicate pancreatic insufficiency or other problems with fat digestion. Exocrine pancreatic function was tested in 64 patients sent to our department within 24 months with suspected EPI by means of SPT,12, 13 quantitative faecal fat analysis,14 and faecal chymotrypsin (Boehringer-Mannheim, Mannheim, Germany) and elastase 1 (Schebo-Tech, D-35435 Wettenberg, Germany) estimations. Hashimotos Success Stories and Gratitude for Healing in 2022, Thyroid-Friendly Recipes for Thanksgiving, The Ultimate Guide To Using Enzymes with Hashimotos, How Myo-inositol Can Improve Hashimotos Symptoms, Approach to Fibrocystic Breasts with Hashimotos, The role of the pancreas and pancreatic elastase, How Hashimotos affects pancreatic enzyme deficiency, Symptoms and testing for pancreatic enzyme deficiencies, Giardia (and potentially other parasitic) infections, Indigestion/fullness 2-4 hours after a meal, Bloating or flatulence 2-4 hours after a meal, Diarrhea, or oil/grease present during bowel movements, Gallbladder pain (right side, under ribs), gallstones, or gallbladder removal, Low vitamin levels (A, D, E, and K) even after supplementing (I see this very often, as the body is not able to absorb and utilize the vitamins in such supplements), Dry, itchy, scaly, or flaky skin, rashes or eczema, Chicken skin (tiny bumps on the back of arms), Immune system imbalance (getting sick more often), Numbness and tingling (peripheral neuropathy). Other causes of insufficiency may include celiac disease, Crohn disease, autoimmune pancreatitis (immunoglobulin G4-related disease), Zollinger-Ellison syndrome, and some surgical procedures that can lead to a decrease in digestive system or pancreatic function. They refer to insufficiency as being 100-200 ug/g. All data is backed up multiple times a day and encrypted using SSL certificates. 2016 Feb 21; 22(7): 23042313. Pancreatic endosonographic findings and clinical correlation in Crohn's disease. Doctors typically provide answers within 24 hours. How to differentiate between UTI and Pregnancy Symptoms? FOIA The determination of enzyme concentration in . Accessed on 3/19/17. Singh VK, Schwarzenberg SJ. The site is secure. Pezzilli, R. et. al. In children, pancreatic insufficiency is most frequently associated with cystic fibrosis (CF) or Shwachman-Diamond syndrome (SDS). This test measures the amount of elastase in your stool. Digestive enzymes break down food, allowing your body to get nutrients. However, this testing is cumbersome for the patient and not easily tolerated due to the requirement of consuming 100 g fat/day. You will need to work with your healthcare team to establish dosage for PERT. If only a single specimen is collected, it must be split prior to transport. Understanding Exocrine Pancreatic Insufficiency (EPI). Mine is also above the lab ref range, >750. Abnormal Reports, SI Normal Reports | The amount of PE in stool is representative of pancreatic enzyme production; patients with EPI may have reduced concentrations of PE in feces. Function Testing. Chronic Pancreatitis. Elastase is an enzyme produced by special (exocrine) tissue in the pancreas. Abstract. Get Started The pancreatic elastase 1 fecal test is used to diagnose insufficiencies of the pancreas that result in diseases such as: - Cystic fibrosis - Chronic pancreatitis - Pancreatic cancer - Inflammatory Bowel Disease - Gallstones Dig Dis Sci. Follow your healthcare providers recommendations for taking PERT, and be sure to take it with every meal or snack. There are no problems recorded in medical literature for high levels of Pancreatic Elastase I. Upload your lab report and well interpret and provide you with recomendations today. SDS is the second most common cause of inherited pancreatic insufficiency, after CF. Dr. Hopson goes on to explain that the pancreatic elastase test, used as an initial screening for exocrine pancreatic insufficiency, is an alternative to fecal fat testing, which can be cumbersome and inconvenient for patients. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. (2013 November 28). Guandalini, S. (2016 September 26 Updated). Lower levels may indicate pancreatic insufficiency or other problems with fat digestion. Hi there, I had mine done as well and it was 800+. Fecal elastase test (FE-1): This test is done to look for an enzyme called elastase that is released from the pancreas during digestion. Pancreatic Elastase is an enzyme produced by exocrine tissue in the pancreas. FELAS. The information on healthmatters.io is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. Cutoff values (microgram/g stool) of < 100 have been suggested as SCP, 100-200 as MCP, and > 200 as normal. Chowdhury SD, Kurien RT, Ramachandran A, et al: Pancreatic exocrine insufficiency: Comparing fecal elastase 1 with 72-h stool for fecal fat estimation. Our internal code of conduct adds additional privacy protection. Pancreatic insufficiency can cause a number of health problems, including malabsorption and . Are pancreas elastase stool results affected by pancreatic enzyme replacement therapy, such as creon? Smaller, frequent meals may help with better absorption. Common tests that your healthcare provider may perform to determine EPI include: 3. <100 mcg/g (Severe Pancreatic Insufficiency), 100-200 mcg/g (Moderate Pancreatic Insufficiency). Coming to a Cleveland Clinic location?Hillcrest Cancer Center check-in changesCole Eye entrance closingVisitation, mask requirements and COVID-19 information, Notice of Intelligent Business Solutions data eventLearn more. Z0925. This test measures the amount of elastase in stool (feces) to help evaluate whether a persons pancreas is functioning properly. Exocrine Pancreatic Insufficiency (EPI). Available online at https://pancreas.org/patients/testing-procedures/functional/. Medscape Drugs and Diseases. Pancreas.org. Hi Sparkle. To prepare for a pancreatic elastase stool test, you should follow your healthcare providers instructions. (2013 April). Disclaimer. 3 Protease and elastase, which break down proteins. Pancreatic elastase concentrations above 200 mcg/g are normal and are not indicative of exocrine pancreatic insufficiency. This form enables patients to ask specific questions about lab tests. It is a key part of your digestive process. The elastase test is used along with other tests, such as fecal fat and/or fecal chymotrypsin, to evaluate both children and adults for pancreatic insufficiency. Fecal pancreatic elastase is a non-invasive marker of exocrine pancreatic function. At HealthMatters, we're committed to maintaining the security and confidentiality of your personal information. The most effective treatment for PEI is pancreatic enzyme replacement therapy (PERT), which involves taking a medication called pancrelipase to provide the body with enzymes that break down fats and proteins. He said range is above >200. GI Effects Stool Profile | Genova Diagnostics, https://www.labcorp.com/test-menu/32666/pancreatic-elastase-fecal, https://www.gdx.net/product/pancreatic-elastase-test-stool, https://www.childrensmn.org/references/lab/urinestool/pancreatic-elastase-stool.pdf, Navigate to GI Effects Stool Profile | Genova Diagnostics. Method Immunoassay Reportable range: 15-500 g/g stool Interpretive Information A result in the normal range is consistent with normal pancreatic function. An alternate to the 72-hour fecal fat test is the measurement of PE in stool. They may find symptom relief and nutritional improvement from prescribed enzymes taken by mouth (oral) and vitamin supplements. We use procedural, physical, and electronic security methods designed to prevent unauthorized people from getting access to this information. al. The level in the stool is decreased when the exocrine tissues of the pancreas are not producing sufficient elastase and other digestive enzymes. Epub 2017 May 13. Hope this helps.. Upload your lab reports and get interpretation today. Pancreatic Exocrine Insufficiency Outlook. See our Privacy Policy for more details. what could cause this? Little (or no) elastase can indicate EPI. official website and that any information you provide is encrypted Clinical symptoms of EPI include steatorrhea, bloating, abdominal discomfort, and weight loss. See our Privacy Policy for more details. Normal Ranges for Pancreatic Elastase in ug/gram fecal matter: Normal: >200 ug elastase/gram fecal matter, Severe pancreatic insufficiency: <100 ug elastase/gram fecal matter, Moderate pancreatic insufficiency: 100-200 ug elastase/gram fecal matter, -https://www.labcorp.com/test-menu/32666/pancreatic-elastase-fecal, -https://www.gdx.net/product/pancreatic-elastase-test-stool, -https://www.childrensmn.org/references/lab/urinestool/pancreatic-elastase-stool.pdf, - Lam KW, Leeds J. Did you ever turn up anything on high elastase? if so, how long to stop creon before test? Available online at https://www.pancreapedia.org/reviews/diagnosis-of-pancreatic-exocrine-insufficiency-in-chronic-pancreatitis. (2013 November 14 Updated). The amount of enzymes needed varies from person-to-person and meal-to-meal, with large, fatty meals requiring more enzymes than small, low-fat meals. This site needs JavaScript to work properly. Lindkvist, B. normal fecal fat, pancreatic elastase, and mg, but higher volume on stool test. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements. Cystic fibrosis is the top cause of EPI in infants and children. An acidic stop solution is added causing the color to change from blue to yellow. notes indicate:it is not necessary to interrupt enzyme substitution thearpy. Normal concentrations do not exclude the possibility of exocrine pancreatic insufficiency. 6, 2005. There are minimal risks associated with a pancreatic elastase . Get useful, helpful and relevant health + wellness information. Diagnosis of exocrine pancreatic insufficiency in case of unexplained diarrhea, constipation, steatorrhea, flatulence, weight loss, upper abdominal pain, and food intolerances, Monitoring of exocrine pancreatic function in cystic fibrosis, diabetes mellitus, or chronic pancreatitis, Enzyme-Linked Immunosorbent Assay (ELISA). and transmitted securely. My result is 800+ ug/g This is above the normal range. If left untreated, patients with EPI can experience weight loss and significant nutrient deficiencies. Nearly 9 in 10 infants with cystic fibrosis develop EPI within the first year. 2014 Oct;2(5):345-54. Should I look out for signs of complications? Pancreatic elastase 1. My pancreatic elastase 1 ?came back at 415 ug/g is this normal ? Methods. If little or no elastase is found in the stool, it may mean that this enzyme is not working as it should. Practical guide to exocrine pancreatic insufficiency Breaking the myths. This test measures the amount of elastase in your stool. The pancreatic elastase test, often referred to as "fecal elastase," is a helpful tool for identifying exocrine pancreatic insufficiency in people who have gastrointestinal symptoms, such as abdominal pain, diarrhea, and unexplained weight loss. Accessed on 3/19/17. (2017 February 10). We've put industry-leading security standards in place to help protect against the loss, misuse, or alteration of the information under our control. *Severe exocrine pancreatic insufficiency: below 100 ug. Careers. Tth AZ, Szab A, Hegyi E, Hegyi P, Sahin-Tth M. Am J Physiol Gastrointest Liver Physiol. (2016 February 21). *Normal exocrine pancreatic sufficiency: 200 to >500 ug E1/g stool *Moderate to mild exocrine pancreatic insufficiency: 100 - 200 ug E1/g stool *Severe exocrine pancreatic insufficiency: below 100 ug. al. Learn more. Indian J Gastroenterol. 2. Preferred shipping temperature is frozen. The lower the level of Pancreatic Elastase I is in the stool, the worse the pancreatic insufficiency is. Hi Linda thanks so much for your response. Accessed on 3/19/17. Shwachman-Diamond Syndrome Foundation. All those with SDS have some degree of pancreatic insufficiency beginning in infancy.