Clinical evaluation of the starch tolerance test.

Early diagnosis of chronic benign or malignant disease of the pancreas is a problem that has haunted physicians for many years. In spite of rather startling advances made in other field, clinical evaluation and a high index of suspicion continue to be the mainstays in the diagnosis of these diseases. Several new laboratory tests or modifications of older tests have been put to trial, the starch tolerance test described by Althausen and Uyeyama 1 being one of these. We have attempted to evaluate this test clinically. The starch tolerance test is based on the premise that pancreatic amylase is the only significant physiologic enzyme responsible for the breakdown of starch into disaccharides. In this form it is absorbed by the intestinal tract. The original authors found that 87% of all patients with chronic benign and malignant disease of the pancreas showed abnormal results on starch tolerance tests. Kalser and coworkers