7 Healthy Habits to Manage EPI

Exocrine pancreatic insufficiency (EPI) is a condition in which the pancreas doesn’t produce enough digestive enzymes. It can cause a number of unpleasant symptoms, including foul-smelling stools, diarrhea, stomach discomfort, bloating, and weight loss.

These symptoms are often greatly reduced, or even eliminated, when you take pancreatic enzyme replacement therapy (PERT) along with meals and make changes to your diet. But even when you take enzymes and follow a prescribed diet, you may still experience some distressing symptoms.

The good news is that certain lifestyle habits can help reduce these symptoms. While their effectiveness may depend on the precise cause of your symptoms, these habits are always beneficial for your overall health.

Healthy Tips for Managing EPI

Incorporate these seven habits into your daily routine to better manage the symptoms of EPI.

1. Don’t smoke. Smoking tobacco can damage your pancreas, says Brooke Glessing, MD, the medical director of the Digestive Health Institute at University Hospitals Ahuja Medical Center in Beachwood, Ohio. “If your pancreas is already challenged,” she says, “further damage could be very detrimental.” She adds that smoking marijuana has also been shown to be toxic to the pancreas.
2. Limit alcohol. Drinking heavily can cause or contribute to chronic pancreatitis, an inflammation of the pancreas that doesn’t heal or improve. And chronic pancreatitis is often the underlying cause of EPI, says Rajesh N. Keswani, MD, a gastroenterologist at Northwestern Memorial Hospital in Chicago and an associate professor of medicine at Northwestern University. Dr. Keswani advises limiting alcohol to one to two drinks a day or avoiding it altogether, depending on the overall health of your pancreas.
3. Stay hydrated. Drinking plenty of fluids is crucial to managing EPI. “Good hydration buffers the pancreas and helps it function more properly,” Dr. Glessing says. Drink plain water and limit sugary drinks, fruit juices, and caffeinated beverages, which can counteract the hydrating effects of water.
4. Exercise regularly. While exercise may not directly affect your pancreas, it’s important for overall health, Glessing says. Keswani adds that what’s good for your cardiovascular health, such as getting enough exercise, also tends to be good for your pancreas.
5. Eat a healthy diet. Just as with regular exercise, a healthy diet is important for your general health and well-being. But it’s especially important for people with EPI to pay attention to diet. According to StatPearls, a key part of managing EPI is to avoid any problems related to malnutrition. This includes eating a healthy diet that includes healthy fats, eating small meals more frequently, and working with a dietitian to plan a diet that meets your individual needs.
6. Manage stress. While there’s little research showing a direct connection between stress and EPI, Glessing says, “Many people say their symptoms flare in a stressful situation.” To remedy the effects of stress, Glessing recommends meditation, yoga, or massage therapy. “Mental well-being is important in all symptoms of the gastrointestinal (GI) tract,” Keswani adds. Seeing a therapist may help; some even specialize in GI problems.
7. See your doctor regularly. Maintaining communication with your doctor is always important, but it’s especially crucial if your EPI symptoms aren’t fully under control, says Keswani. If you’re not sure whether your current EPI treatment is working as well as it should, address that concern with your doctor.

Dietary changes or adjustments in enzyme dosing may help curb EPI symptoms. But don’t attempt to make treatment changes on your own. Work closely with your doctor to determine the best way to manage your EPI.