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.
What Is Exocrine Pancreatic Insufficiency? Symptoms, Causes, Diagnosis, Treatment, and PreventionMedically Reviewed by Waseem Ahmed, MD | January 28, 2024
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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.
How is EPI diagnosed?
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.
What causes EPI?
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.
How is EPI treated?
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.
Can EPI be cured?
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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Yuying Luo, MD
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Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care ...
Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patien...
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What Is Exocrine Pancreatic Insufficiency? Symptoms, Causes, Diagnosis, Treatment, and PreventionMedically Reviewed by Waseem Ahmed, MD | January 28, 2024
