{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:31:57Z","timestamp":1776893517324,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,10,10]],"date-time":"2017-10-10T00:00:00Z","timestamp":1507593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Mylan"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>A previous UK study showed that 6.1% of patients with diarrhea\u2010predominant irritable bowel syndrome (IBS\u2010D) had evidence of severe pancreatic exocrine insufficiency (PEI), but these findings need replication. We aimed to identify the prevalence of PEI based on fecal elastase stool testing in consecutive outpatients presenting with chronic unexplained abdominal pain and\/or diarrhea and\/or IBS\u2010D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients aged over 40\u00a0years presenting to hospital outpatient clinics from six sites within Australia with unexplained abdominal pain and\/or diarrhea for at least 3\u00a0months and\/or IBS\u2010D were studied. Patients completed validated questionnaires and donated a stool sample in which elastase concentration was measured by ELISA. A concentration of &lt;\u00a0100\u00a0mcg\/g stool represented severe and &lt;\u00a0200\u00a0mcg\/g mild to moderate PEI. Patients whose fecal elastase was &lt;\u00a0200\u00a0mcg\/g underwent testing for pancreatic pathology with an endoscopic ultrasound or abdominal CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred eighteen patients (mean age of 60\u00a0years, 29.4% male) were studied. PEI was found in 4.6% (95% CI 2.2\u20138.3%) (<jats:italic>n<\/jats:italic>\u00a0=\u00a010), with five patients (2.3% (95% CI 0.8\u20135.3%) having severe PEI. Only male sex and heavy alcohol use were significantly associated with abnormal <jats:italic>versus<\/jats:italic> normal pancreatic functioning. Of seven patients who underwent endoscopic ultrasound or CT, two had features indicative of chronic pancreatitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>One in 50 patients with IBS\u2010D or otherwise unexplained abdominal pain or diarrhea have an abnormal fecal elastase, but unexpected pancreatic insufficiency was detected in only a minority of these. This study failed to confirm the high prevalence of PEI among patients with unexplained GI symptoms previously reported.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.13791","type":"journal-article","created":{"date-parts":[[2017,3,24]],"date-time":"2017-03-24T06:05:57Z","timestamp":1490335557000},"page":"1813-1817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Undiagnosed pancreatic exocrine insufficiency and chronic pancreatitis in functional GI disorder patients with diarrhea or abdominal pain"],"prefix":"10.1111","volume":"32","author":[{"given":"Nicholas J","family":"Talley","sequence":"first","affiliation":[{"name":"Faculty of Health and Medicine University of Newcastle  Callaghan New South Wales Australia"},{"name":"Department of Gastroenterology John Hunter Hospital  New Lambton New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerald","family":"Holtmann","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quoc Nam","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Royal Adelaide Hospital  Adelaide South Australia Australia"},{"name":"Discipline of Medicine University of Adelaide  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Monash University and Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Bampton","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Flinders Medical Centre  Bedford Park South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Veysey","sequence":"additional","affiliation":[{"name":"Teaching &amp; Research Unit Gosford &amp; Wyong Hospital  Gosford New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Wong","sequence":"additional","affiliation":[{"name":"Mylan EPD  Macquarie New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Philcox","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology John Hunter Hospital  New Lambton New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natasha","family":"Koloski","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine University of Newcastle  Callaghan New South Wales Australia"},{"name":"Department of Gastroenterology John Hunter Hospital  New Lambton New South Wales Australia"},{"name":"Department of Gastroenterology Princess Alexandra Hospital  Woolloongabba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Bunby","sequence":"additional","affiliation":[{"name":"Faculty of Health and Medicine University of Newcastle  Callaghan New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Psychology Macquarie University  Ryde New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,10,10]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01328.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05783.x"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2016.02.031"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2013.01.068"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.09.032"},{"key":"e_1_2_5_7_1","first-page":"361","article-title":"The incidence and clinical relevance of chronic inflammation in the pancreas in autopsy material","volume":"86","author":"Olsen T","year":"1978","journal-title":"Acta Path. 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