Just a short update. I have an MRCP (magnetic imaging with contrast) and ultrasound. I've also seen a specialist in the field. The bottom line is that imaging looks fine however there was quite a bit of concern over the low elastase. He has basically said my pancreas is not functioning as it should but the cause is unknown. The knock on effect is ongoing digestion issues. He has upped my enzymes intake (most research suggested 30,000 UI min (link)). I basically need to monitor symptoms and if a bout of extreme pain occurs, go to the ER for amylase and lipase test which only peak hours after an attack. The main concern is chronic pancreatitis which is highly correlated with low elastase. Here hoping its not that!