Exocrine Pancreatic Insufficiency Resource Center
Health ConditionsDigestive HealthExocrine Pancreatic Insufficiency

Exocrine Pancreatic Insufficiency

Exocrine pancreatic insufficiency (EPI) is a condition in which your pancreas doesn’t make enough of the enzymes needed to digest food properly, especially fats. This can lead to problems with nutrient absorption and cause symptoms like diarrhea, abdominal pain, bloating, and weight loss as well as fatty, foul-smelling stools that float (steatorrhea).

Various factors can lead to EPI, including chronic pancreatitis, cystic fibrosis, and digestive tract surgery. Treatment typically involves pancreatic enzyme replacement therapy (PERT), which helps your body digest fats, along with a high-fat, high-calorie diet and vitamin supplementation.

FAQ

What are the symptoms of EPI?

Common symptoms include diarrhea, abdominal pain, bloating, and weight loss. Stools might be loose, greasy, and foul-smelling, and you might notice that you’re passing more gas or losing weight unexpectedly. EPI malabsorption might also cause bone and vision problems.

Diagnosis often involves a test that measures fat levels in the stool, another that looks at levels of elastase (a pancreatic enzyme that supports digestion), and sometimes a test to see how the pancreas responds to a hormone called secretin, which triggers the release of elastase.

Chronic pancreatitis is the leading cause of EPI in adults, and cystic fibrosis most often causes it in children. Other common causes include digestive tract surgery, pancreatic cancer, inflammatory bowel disease, diabetes, and certain genetic conditions.

EPI treatment usually involves eating a high-calorie, high-fat diet and taking pancreatic enzyme replacement therapy (PERT) with meals to aid digestion. You might also need supplements to replace fat-soluble vitamins, including vitamins A, D, E, and K.

EPI itself may not always be curable, but you can manage its symptoms effectively with treatment and improve your quality of life. Roughly 50 percent of all children with EPI start to produce enzymes later in life, and some can stop PERT.

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Resources
  1. Exocrine Pancreatic Insufficiency (EPI). The National Pancreas Foundation.
  2. Exocrine Pancreatic Insufficiency (EPI). Cleveland Clinic.

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