Exocrine pancreatic insufficiency (EPI)

[The Health Guy]

Exocrine pancreatic insufficiency or EPI is characterized by the pancreas NOT producing enough pancreatic enzymes (protease, amylase, lipase) to promote normal digestion and the need for pancreatic enzyme supplementation.

What Causes Exocrine Pancreatic Insufficiency?

There are more causes for EPI than most people think. Some of the conditions that cause EPI are:

• chronic pancreatitis
• cystic fibrosis
• obstructions of the pancreatic duct (cancer, tumors)
• Shwachman-Diamond syndrome (SDS)
• Celiac disease
• Crohn disease
• Autoimmune pancreatitis: This is often caused by immunoglobulin G4 (IgG4)-related disease and can progress to EPI.
• Zollinger-Ellison syndrome
• GI and pancreatic surgical procedures

What Are The Symptoms of EPI?

• Frequent diarrhea. EPI can cause problems with the digestion process. As a result undigested food can move too quickly through the digestive tract. Not all people experience this symptom. There are many causes of diarrhea so just because you have a couple days of it does not mean you have pancreatic insufficiency. However, if you do have (been diagnosed) with any of the above conditions that can cause EPI it would be prudent to ask your doctor to test you (especially if you have some of the following symptoms as well).
• Weight loss. People with EPI cannot digest fats, proteins, and carbohydrates found in the food they eat, which can result in weight loss.
• Gas and bloating. People with EPI cannot properly digest the food they eat, which can result in uncomfortable symptoms like gas and bloating.
• Stomach pain. The gas and bloating caused by maldigestion in people with EPI will frequently result in stomach pain.
• Foul-smelling, greasy stools (steatorrhea). Steatorrhea is a type of bowel movement that is oily, floats, smells really bad, and is difficult to flush. People with EPI are not able to absorb all of the fat that they eat, so undigested fat is excreted, resulting in stools that look oily or greasy. Not all people experience this symptom. Talk to your doctor if you notice oil droplets floating in the toilet bowl or stools that float or stick to the sides of the bowl and are hard to flush; it may be a sign of EPI.

[Author]

Posts