What is the initial diagnostic test for chronic pancreatitis?

Stool elastase measurement is recognized as a valuable initial diagnostic test for chronic pancreatitis. This test assesses pancreatic exocrine function by measuring the concentration of elastase in a stool sample. In chronic pancreatitis, the exocrine function of the pancreas frequently deteriorates over time, leading to insufficient digestive enzyme production, which can result in decreased elastase levels in the stool. Therefore, a low level of stool elastase can indicate pancreatic insufficiency, which is a key aspect of chronic pancreatitis.

While other tests can be helpful in diagnosing chronic pancreatitis, such as imaging studies like abdominal CT or endoscopic ultrasound, stool elastase provides a non-invasive and direct measure of the functional status of the pancreas. Additionally, amylase levels are usually more relevant in the context of acute pancreatitis and tend to be normal or only slightly elevated in chronic conditions, making them less useful for diagnosing chronic pancreatitis specifically.

Thus, stool elastase serves as an important initial test that can guide further evaluation and management of patients suspected to have chronic pancreatitis.