Skip to main content
PMC home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1988 May;81(5):270–273. doi: 10.1177/014107688808100511

Evaluation of a tubeless pancreatic function test in patients with steatorrhoea in a district general hospital.

S R Gould 1, G L Chinn 1, B T Nobbs 1, G A Lewis 1
PMCID: PMC1291585  PMID: 3290481

Abstract

The Pancreolauryl Test (PLT), a tubeless pancreatic function test, has been evaluated in an unselected series of outpatients with steatorrhoea presenting to a district general hospital (DGH). This is the first study of the PLT in a DGH, involving an unselected series of patients and not those from secondary or tertiary referral hospitals. Health controls (n = 15) and patients with self-limiting diarrhoea (n = 8) had normal urinary excretion indices (greater than or equal to 30). Coeliac disease (n = 13) and small bowel bacterial overgrowth (n = 12) were the commonest causes of steatorrhoea and there were no false-positive results in these patients. The mean urinary excretion index in patients with untreated coeliac disease (mean index = 38%) was lower than in healthy controls (n = 15, mean index = 53%; P less than 0.05 greater than 0.02). No patient with proven pancreatic steatorrhoea had a normal PLT result, confirming the high negative predictive value found by others. Low results in patients with steatorrhoea following gastric surgery indicate poor mixing of food with pancreatic juices. The PLT proved to be a simple, inexpensive and noninvasive outpatient screening test suitable for use in a DGH to exclude a pancreatic origin of steatorrhoea.

Full text

PDF
271

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ansaldi N., Oderda G. Exocrine pancreatic insufficiency in celiac sprue. Gastroenterology. 1981 Apr;80(4):883–883. [PubMed] [Google Scholar]
  2. BENSON G. D., KOWLESSAR O. D., SLEISENGER M. H. ADULT CELIAC DISEASE WITH EMPHASIS UPON RESPONSE TO THE GLUTEN-FREE DIET. Medicine (Baltimore) 1964 Jan;43:1–40. doi: 10.1097/00005792-196401000-00001. [DOI] [PubMed] [Google Scholar]
  3. Boyd E. J., Cumming J. G., Cuschieri A., Wood R. A., Wormsley K. G. Prospective comparison of the fluorescein-dilaurate test with the secretin-cholecystokinin test for pancreatic exocrine function. J Clin Pathol. 1982 Nov;35(11):1240–1243. doi: 10.1136/jcp.35.11.1240. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cavallini G., Piubello W., Brocco G., Micciolo R., Chech G., Angelini G., Benini L., Riela A., Dalle Molle L., Vantini I. Serum PABA and fluorescein in the course of Bz-Ty-PABA and pancreolauryl test as an index of exocrine pancreatic insufficiency. Dig Dis Sci. 1985 Jul;30(7):655–663. doi: 10.1007/BF01308415. [DOI] [PubMed] [Google Scholar]
  5. DEMOLE M. J., HOWARD E. M. [Use of the nile blue reaction in diagnosis of steatorrhea]. Am J Dig Dis. 1958 Jul;3(7):549–556. doi: 10.1007/BF02231255. [DOI] [PubMed] [Google Scholar]
  6. DREILING D. A. The pancreatic secretion in the malabsorption syndrome and related malnutrition states. J Mt Sinai Hosp N Y. 1957 May-Jun;24(3):243–250. [PubMed] [Google Scholar]
  7. DiMagno E. P., Go W. L., Summerskill W. H. Impaired cholecystokinin-pancreozymin secretion, intraluminal dilution, and maldigestion of fat in sprue. Gastroenterology. 1972 Jul;63(1):25–32. [PubMed] [Google Scholar]
  8. Fernanez L. B., De Paula A., Prizont R., Tiscornia O. M., Braguinsky J., Carreras A., Hojman D. Exocrine pancreas insufficiency secondary to glutenenteropathy. Am J Gastroenterol. 1970 Jun;53(6):564–569. [PubMed] [Google Scholar]
  9. Goldstein R., Blondheim O., Levy E., Stankiewicz H., Freier S. The fatty meal test: an alternative to stool fat analysis. Am J Clin Nutr. 1983 Nov;38(5):763–768. doi: 10.1093/ajcn/38.5.763. [DOI] [PubMed] [Google Scholar]
  10. Kaffarnik H., Meyer-Bertenrath J. G. Zur Methodik und klinischen Bedeutung eines neuen Pankreaslipase-Tests mit Fluoresceindilaurinsäureester. Klin Wochenschr. 1969 Feb 15;47(4):221–223. doi: 10.1007/BF01725679. [DOI] [PubMed] [Google Scholar]
  11. Kaffernik H., Klimkeit P., Zöfel P., Otte U., Meyer-Bertenrath J. G. Zur klinischen Wertigkeit des oralen Pankreasfunktionstets mit Fluoreszein-Dilaurat. MMW Munch Med Wochenschr. 1977 Nov 11;119(45):1467–1470. [PubMed] [Google Scholar]
  12. Kay G., Hine P., Braganza J. The pancreolauryl test. A method of assessing the combined functional efficacy of pancreatic esterase and bile salts in vivo? Digestion. 1982;24(4):241–245. doi: 10.1159/000198803. [DOI] [PubMed] [Google Scholar]
  13. Keller J., Ornsholt J., Andersen F., Munck V. Reproducibility of the fluorescein dilaurate pancreatic function test. Scand J Clin Lab Invest. 1985 Nov;45(7):585–588. doi: 10.3109/00365518509155264. [DOI] [PubMed] [Google Scholar]
  14. Kilander A. F., Hanssen L. E., Gillberg R. E. Secretin release in coeliac disease. Plasma secretin concentration and bicarbonate output to the duodenum after intraduodenal acid infusion in coeliac patients before and after treatment. Scand J Gastroenterol. 1983 Sep;18(6):765–769. doi: 10.3109/00365528309182092. [DOI] [PubMed] [Google Scholar]
  15. Kowlessar O. D., Phillips L. D. Celiac disease. Med Clin North Am. 1970 May;54(3):647–656. [PubMed] [Google Scholar]
  16. Lankisch P. G., Brauneis J., Otto J., Göke B. Pancreolauryl and NBT-PABA tests. Are serum tests more practicable alternatives to urine tests in the diagnosis of exocrine pancreatic insufficiency? Gastroenterology. 1986 Feb;90(2):350–354. [PubMed] [Google Scholar]
  17. Lankisch P. G., Schreiber A., Otto J. Pancreolauryl test. Evaluation of a tubeless pancreatic function test in comparison with other indirect and direct tests for exocrine pancreatic function. Dig Dis Sci. 1983 Jun;28(6):490–493. doi: 10.1007/BF01308149. [DOI] [PubMed] [Google Scholar]
  18. Maton P. N., Selden A. C., Fitzpatrick M. L., Chadwick V. S. Defective gallbladder emptying and cholecystokinin release in celiac disease. Reversal by gluten-free diet. Gastroenterology. 1985 Feb;88(2):391–396. doi: 10.1016/0016-5085(85)90497-4. [DOI] [PubMed] [Google Scholar]
  19. Regan P. T., DiMagno E. P. Exocrine pancreatic insufficiency in celiac sprue: a cause of treatment failure. Gastroenterology. 1980 Mar;78(3):484–487. [PubMed] [Google Scholar]
  20. Ventrucci M., Gullo L., Daniele C., Priori P., Labò G. Pancreolauryl test for pancreatic exocrine insufficiency. Am J Gastroenterol. 1983 Dec;78(12):806–809. [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES