What is EPI?

Exocrine Pancreatic Insufficiency (EPI)

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 is not making enough pancreatic enzymes then this can result in the inability to digest food properly, or maldigestion.1-4 That's an important job!

EPI occurs when the pancreas doesn't make enough of the enzymes necessary to digest the food you eat. The pancreas produces the main digestive enzymes lipase, protease, and amylase.

Signs & Symptoms of EPI

When you have EPI, your body cannot properly absorb nutrients from fats, proteins, and carbohydrates. People with EPI suffer from a number of gastrointestinal (GI) symptoms and may not get the necessary nutrition from their diet. Because the signs and symptoms of EPI are similar to those of other GI diseases. EPI may go undetected.5

Symptoms of EPI may include

  • Stomach pain/cramps
  • Weight loss
  • Bloating
  • Gas
  • Loose, oily, foul-smelling stools that are difficult to flush (steatorrhea)
  • Diarrhea

Do you have any of these symptoms?

Be sure to talk to your doctor about all your symptoms. Your doctor may be able to provide an accurate diagnosis and discuss treatment options, or refer you to a doctor who specializes in treating disorders of the GI tract.

Download the EPI Doctor Discussion Guide

How is EPI Diagnosed?

EPI can be tough to diagnose since symptoms are similar to those of other GI diseases. The following tests are commonly used to help diagnose EPI:

Stool Test

Fecal elastase test: Measures the amount of an enzyme (elastase) produced by the pancreas, in your stool

Fecal fat test : Measures the amount of fat in your stool

Blood Test

Measures the concentration of a protein (trypsinogen) produced by the pancreas that is found in your blood

Endoscopic retrograde cholangiopancreatography (ERCP)

Takes pictures of the pancreas to look for damage, using a flexible tube that is inserted through the mouth and travels through the stomach

For Healthcare Professionals

The information provided in this website is intended for U.S. healthcare professionals only.

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IMPORTANT RISK INFORMATION
What is the most important information I should know about ZENPEP?
  • ZENPEP® (pancrelipase) may increase your chance of having a rare bowel disorder called fibrosing colonopathy. This condition is serious and may require surgery. The risk of having fibrosing colonopathy may be reduced by following the dosing instructions your doctor gave you. Call your doctor right away if you have any unusual or severe: stomach area (abdominal) pain, bloating, trouble passing stool (having bowel movements), nausea, vomiting, or diarrhea.
  • Take ZENPEP exactly as prescribed. Do not take more or less ZENPEP than directed by your doctor.
Before you take ZENPEP, tell your doctor:
  • If you are allergic to pork (pig) products; have a history of blockage of your intestines, or scarring or thickening of your bowel wall (fibrosing colonopathy); have gout, kidney disease, or high blood uric acid (hyperuricemia); have trouble swallowing capsules; have any other medical condition; are pregnant or plan to become pregnant; are breastfeeding or plan to breastfeed.
  • About all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
How should I take ZENPEP?
  • Take ZENPEP exactly as your doctor tells you.
  • Do not crush or chew the ZENPEP capsule or its contents, and do not hold the capsule or contents in your mouth. This may cause irritation in your mouth or change the way ZENPEP works in your body. See Medication Guide and talk to your doctor for additional directions.
Side Effects
  • ZENPEP may cause serious side effects, including worsening of swollen, painful joints (gout) caused by an increase in blood uric acid levels and allergic reactions including trouble with breathing, skin rashes, or swollen lips. Call your doctor right away if you have any of these symptoms.
  • The most common side effects of ZENPEP include belly pain, gas, and headache.
  • ZENPEP and other pancreatic enzyme products are made from the pancreas of pigs, the same pigs people eat as pork. These pigs may carry viruses. Although it has never been reported, it may be possible for a person to get a viral infection from taking pancreatic enzyme products that come from pigs.
  • Tell your doctor if you have any side effect that bothers you or does not go away. These are not all the possible side effects of ZENPEP. For more information, ask your doctor or pharmacist.
What is ZENPEP?

    ZENPEP is a prescription medicine for people who cannot digest food normally because their pancreas does not make enough enzymes. ZENPEP may help your body use fats, proteins, and sugars from food. ZENPEP contains a mixture of digestive enzymes (lipases, proteases, and amylases) from pig pancreas. ZENPEP is safe and effective in children.

    Please also see Medication Guide within the full Prescribing Information.

References

    1. Wooldridge JL, Heubi JE, Amaro-Galvez R, et al. EUR-1008 pancreatic enzyme replacement is safe and effective in patients with cystic fibrosis and pancreatic insufficiency. J Cyst Fibros. 2009;8:405-417. 2. Al-Kaade S. Exocrine pancreatic insufficiency. Medscape website. http://emedicine.medscape.com /article/2121028- overview. Accessed March 16, 2017. 3. Hardt PD, Ewald N. Exocrine pancreatic insufficiency in diabetes mellitus: a complication of diabetic neuropathy or a different type of diabetes? Exp Diabetes Res. 2011;2011:1-7. 4. Domínguez-Muñoz JE. Pancreatic exocrine insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26(suppl 2):12-16. 5. Domínguez-Muñoz JE. Chronic pancreatitis and persistent steatorrhea: what is the correct dose of enzymes? Clin Gastroenterol Hepatol. 2011;9:541-546.

IMPORTANT RISK INFORMATION More Less
What is the most important information I should know about ZENPEP?
  • ZENPEP® (pancrelipase) may increase your chance of having a rare bowel disorder called fibrosing colonopathy. This condition is serious and may require surgery. The risk of having fibrosing colonopathy may be reduced by following the dosing instructions your doctor gave you. Call your doctor right away if you have any unusual or severe: stomach area (abdominal) pain, bloating, trouble passing stool (having bowel movements), nausea, vomiting, or diarrhea.
  • Take ZENPEP exactly as prescribed. Do not take more or less ZENPEP than directed by your doctor.
Before you take ZENPEP, tell your doctor:
  • If you are allergic to pork (pig) products; have a history of blockage of your intestines, or scarring or thickening of your bowel wall (fibrosing colonopathy); have gout, kidney disease, or high blood uric acid (hyperuricemia); have trouble swallowing capsules; have any other medical condition; are pregnant or plan to become pregnant; are breastfeeding or plan to breastfeed.
  • About all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
How should I take ZENPEP?
  • Take ZENPEP exactly as your doctor tells you.
  • Do not crush or chew the ZENPEP capsule or its contents, and do not hold the capsule or contents in your mouth. This may cause irritation in your mouth or change the way ZENPEP works in your body. See Medication Guide and talk to your doctor for additional directions.
Side Effects
  • ZENPEP may cause serious side effects, including worsening of swollen, painful joints (gout) caused by an increase in blood uric acid levels and allergic reactions including trouble with breathing, skin rashes, or swollen lips. Call your doctor right away if you have any of these symptoms.
  • The most common side effects of ZENPEP include belly pain, gas, and headache.
  • ZENPEP and other pancreatic enzyme products are made from the pancreas of pigs, the same pigs people eat as pork. These pigs may carry viruses. Although it has never been reported, it may be possible for a person to get a viral infection from taking pancreatic enzyme products that come from pigs.
  • Tell your doctor if you have any side effect that bothers you or does not go away. These are not all the possible side effects of ZENPEP. For more information, ask your doctor or pharmacist.
What is ZENPEP?

    ZENPEP is a prescription medicine for people who cannot digest food normally because their pancreas does not make enough enzymes. ZENPEP may help your body use fats, proteins, and sugars from food. ZENPEP contains a mixture of digestive enzymes (lipases, proteases, and amylases) from pig pancreas. ZENPEP is safe and effective in children.

    Please also see Medication Guide within the full Prescribing Information.

References

    1. Wooldridge JL, Heubi JE, Amaro-Galvez R, et al. EUR-1008 pancreatic enzyme replacement is safe and effective in patients with cystic fibrosis and pancreatic insufficiency. J Cyst Fibros. 2009;8:405-417. 2. Al-Kaade S. Exocrine pancreatic insufficiency. Medscape website. http://emedicine.medscape.com /article/2121028- overview. Accessed March 16, 2017. 3. Hardt PD, Ewald N. Exocrine pancreatic insufficiency in diabetes mellitus: a complication of diabetic neuropathy or a different type of diabetes? Exp Diabetes Res. 2011;2011:1-7. 4. Domínguez-Muñoz JE. Pancreatic exocrine insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26(suppl 2):12-16. 5. Domínguez-Muñoz JE. Chronic pancreatitis and persistent steatorrhea: what is the correct dose of enzymes? Clin Gastroenterol Hepatol. 2011;9:541-546.