What Is Exocrine Pancreatic Insufficiency (EPI)?

EPI can make mealtime difficult.

EPI is when someone can’t digest their food normally because their pancreas isn’t making enough enzymes. The enzymes help break down the food you eat so it can be absorbed into your body. If your body isn’t making enough pancreatic enzymes, this can result in not being able to digest food properly, or maldigestion. This can be uncomfortable and lead to food-driven gastrointestinal (GI) symptoms.

EPI often happens because of these conditions:

  • Pancreatic cancer
  • Cystic fibrosis
  • Diabetes (types 1 and 2)
  • Chronic pancreatitis

Your pancreas is a gland in your body that makes enzymes
to digest food.

Pancreas diagram

Symptoms of EPI include:

  • Abdominal pain
  • Bloating
  • Flatulence
  • Frequent stools
  • Nausea
  • Malaise
    (general discomfort)
  • Diarrhea
  • Steatorrhea
    (foul-smelling, bulky, oily stools)

Do you have any of these symptoms?

Be sure to talk to your doctor about all your symptoms. Your doctor may be able to help figure out what's happening and recommend treatment options. Your doctor may also refer you to another doctor who specializes in treating GI conditions.


How is EPI diagnosed?

EPI can be hard to diagnose because it causes symptoms similar to other GI conditions.

These tests can help diagnose EPI:

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Stool Test

  • Fecal elastase test: Measures the amount of an enzyme (elastase) produced by the pancreas and found in your stool
  • Fecal fat test: Measures the amount of fat in your stool
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Blood Test

  • Measures the amount of a certain protein made by the pancreas and found in the blood
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  • Takes pictures of the pancreas to look for damage

Managing EPI includes:

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Pancreatic enzyme replacement therapy

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Maintaining adequate nutritional status with vitamin/nutrient supplements

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Lifestyle and dietary modifications