What is involved in secretin test in in the workup of exocrine pancreatic insufficiency (EPI)?

Updated: Aug 12, 2021
  • Author: Samer Al-Kaade, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
  • Print

In the secretin test, porcine or human synthetic secretin is given in doses ranging from 0.5 to 5 clinical units (CU)/kg. Duodenal fluid is continuously collected in 15-minute aliquots for 1 hour. The fluid is analyzed for bicarbonate concentration, volume, and total bicarbonate output.

A bicarbonate concentration lower than 80 mEq/L in all 4 aliquots represents exocrine insufficiency. A peak bicarbonate cutoff of 90 mEq/L has been advocated by some investigators. A peak bicarbonate concentration lower than 50 mEq/L is indicative of severe exocrine insufficiency. When the bicarbonate concentration is equivocal, volume and total bicarbonate output are used as secondary diagnostic parameters.

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!