Abstract
Simultaneous measurements of duodenal and faecal chymotrypsin were made in 30 children aged 3 weeks to 14 years. Apparent chymotrypsin secretion rates measured after stimulation with pancreozymin were compared with the mean faecal chymotrypsin concentration derived from three stool specimens collected at random within 72 hours of the intraduodenal test. In the 25 children who responded to pancreozymin stimulation the mean faecal chymotrypsin concentration was significantly positively correlated with the apparent chymotrypsin secretion rate. Correlation using single specimen stools collected at random was appreciably poorer. In the five children with undetectable or only traces of chymotrypsin in the duodenum after stimulation, the mean faecal chymotrypsin concentrations were only 3-10% of the lower limit of the reference interval. In a second group of 46 children with cystic fibrosis proved by sweat tests and clinical evidence of malabsorption, the chymotrypsin concentration measured in a single stool specimen collected at random was unequivocally subnormal in each case. Faecal chymotrypsin measurement is a rapid, simple, cheap, readily repeated, non-invasive test of high specificity and sensitivity. Faecal chymotrypsin should be measured before contemplating intraduodenal tests of pancreatic function.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Barbero G. J., Sibinga M. S., Marino J. M., Seibel R. Stool trypsin and chymotrypsin. Value in the diagnosis of pancreatic insufficiency in cystic fibrosis. Am J Dis Child. 1966 Dec;112(6):536–540. doi: 10.1001/archpedi.1966.02090150080005. [DOI] [PubMed] [Google Scholar]
- Cann P. A., Read N. W., Brown C., Hobson N., Holdsworth C. D. Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns. Gut. 1983 May;24(5):405–411. doi: 10.1136/gut.24.5.405. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DiMagno E. P. Diagnosis of chronic pancreatitis: are noninvasive tests of exocrine pancreatic function sensitive and specific? Gastroenterology. 1982 Jul;83(1 Pt 1):143–146. [PubMed] [Google Scholar]
- Dürr H. K., Otte M., Forell M. M., Bode J. C. Fecal chymotroypsin: a study on its diagnostic value by comparison with the secretin-cholecystokinin test. Digestion. 1978;17(5):404–409. doi: 10.1159/000198143. [DOI] [PubMed] [Google Scholar]
- Kaspar P., Neumann U. The distribution of chymotrypsin within the feces and description of a new device for the preparation of stool samples. Clin Chem. 1984 Nov;30(11):1864–1866. [PubMed] [Google Scholar]
- Lami F., Callegari C., Miglioli M., Barbara L. A single-specimen fecal chymotrypsin test in the diagnosis of pancreatic insufficiency: correlation with secretin-cholecystokinin and NBT-PABA tests. Am J Gastroenterol. 1984 Sep;79(9):697–700. [PubMed] [Google Scholar]
- Layer P., Go V. L., DiMagno E. P. Fate of pancreatic enzymes during small intestinal aboral transit in humans. Am J Physiol. 1986 Oct;251(4 Pt 1):G475–G480. doi: 10.1152/ajpgi.1986.251.4.G475. [DOI] [PubMed] [Google Scholar]
- Moeller D. D., Dunn G. D., Klotz A. P. Diagnosis of pancreatic exocrine insufficiency by fecal chymotrypsin activity. Am J Dig Dis. 1973 Sep;18(9):792–796. doi: 10.1007/BF01070849. [DOI] [PubMed] [Google Scholar]
- Rubaltelli F. F., Largajolli G. Effect of light exposure on gut transit time in jaundiced newborns. Acta Paediatr Scand. 1973 Mar;62(2):146–148. doi: 10.1111/j.1651-2227.1973.tb08082.x. [DOI] [PubMed] [Google Scholar]
- Sale J. K., Goldberg D. M., Thjodleifsson B., Wormsley K. G. Trypsin and chymotrypsin in duodenal aspirate and faeces in response to secretin and cholecystokinin-pancreozymin. Gut. 1974 Feb;15(2):132–138. doi: 10.1136/gut.15.2.132. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Scotta M. S., Marzani M. D., Maggiore G., De Giacomo C., Melzi D'Eril G. V., Moratti R. Fecal chymotrypsin: a new diagnostic test for exocrine pancreatic insufficiency in children with cystic fibrosis. Clin Biochem. 1985 Aug;18(4):233–234. doi: 10.1016/s0009-9120(85)80046-1. [DOI] [PubMed] [Google Scholar]