PMN elastase (feces)

PMN elastase (feces) too high

A raised value points to inflammatory cells in the gut. This may fit a bacterial gut infection, use of anti-inflammatory painkillers (NSAIDs) or chronic inflammatory bowel disease such as Crohn's disease or ulcerative colitis, especially with long-lasting diarrhea, blood or mucus in the stool and weight loss. Blood in the stool, including menstrual blood, can raise the value. Calprotectin in the stool has been studied better for this question.

PMN elastase (feces) too low

For most of these markers, a low value is the usual result. A low value then has no further meaning. It does not rule out a bowel condition; to rule out a chronic inflammation of the bowel, calprotectin in the stool has been studied better.

Useful for

In people without symptoms, an abnormal result says little, because the meaning has not been established and a passing infection or a painkiller can raise the value. With long-lasting diarrhea or abdominal symptoms, the GP uses calprotectin in the stool to rule out a chronic inflammation of the bowel, and a blood test if celiac disease is suspected. With blood in the stool, unintended weight loss, diarrhea at night or new bowel symptoms after age 50, this test is no substitute for a visit to the GP.

How common is it?

Bowel symptoms are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults in the Netherlands. Chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis are much rarer; the guideline gives no Dutch figure for them. How often an abnormal result for these markers occurs in people without symptoms is not known.

Dutch medical specialists' guideline (FMS) on irritable bowel syndrome (NHG and NVMDL)