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

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.