Determination of subclinical pancreatic exocrine insufficiency by fecal elastase in ibd patients during remission

Aim:It is known that inflammatory bowel disease (IBD) is a risk for exocrine pancreatic insufficiency.Tests for pancreatic enzyme insufficiency are usually invasive and are not suitable for screening.The aim of this study is to determine by using noninvasive and rapid measurement during routine controls that the complaints such as abdominal pain and bloating in patients with IBD who are in remission as clinical and endoscopic are due to subclinical pancreatic insufficiency. Thus, it will be possible to start the correct treatment of pancreatic insufficiency before it becomes evident by avoiding unnecessary escalation of IBD treatment in patients. Materials and Methods:This study included 58 patients (39 males and 19 females aged 18-70 years) from the Gastroenterology polyclinic of Ataturk Education and Research Hospital who has IBD and had been in remission clinically and endoscopically for the last 6 months but had complaints such as bloating and abdominal pain. The control group included 30 healthy individuals (18 males and 12 females aged 18-70 years) who had no alcohol use, cancer and inflammatory bowel disease. Blood and stool samples were taken from the patients and control groups simultaneously. Blood samples were analysed in the biochemistry laboratory on the same day. Stool samples were stored at -80 ° C until the day of analysis. The collected samples were analysed within 4 months. Fecal elastase (FE) was used as a marker in the diagnosis of pancreatic exocrine insufficiency in stool specimens. Fecal elastase level was determined using Bioserv Diagnostics Fecal Pancreatic Elastase ELISA kit. The principle of the test is the sandwich micro ELISA method. The obtained absorbance values ​​ were evaluated as FE µg / gram stool from the standard calibration curve obtained by standards. As previously reported, fecal elastase was evaluated as normal with levelsof 201-500 µg / g. 100-200 µg / g levels Bioserv Diagnostics Fecal Pancreatic Elastase ELISA kit. The principle of the test is the sandwich micro ELISA method. The obtained absorbance values ​​ were evaluated as FE µg / gram stool from the standard calibration curve obtained by standards. As previously reported, fecal elastase was evaluated as normal with levelsof 201-500 µg / g. 100-200 µg / g levelsof fecal elastase accepted as mild to moderate pancreatic insufficiency, and levels<99 µg / g as severe pancreatic insufficiency. FE levels of the patient group were compared with the healthy control group. Results: The mean fecal elastase values ​​of the patient group were 401 ± 179.4 µg / g. The mean fecal elastase level was 396 ± 196 µg / g in ulcerative colitis and 410.2 ± 140 µg / g in Crohn's patients group. Fecal elastase level in the control group was 387.9 ± 194 µg / g. There was no statistically significant difference between the patient and control groups in fecal elastase levels. Conclusion:There was no difference between age and sex matched IBD group patients in remissionand control group in fecal elastase levels. Key Words:Fecal elastase, Inflammatory bowel disease, Pancreatic insufficiency