A digital image of the internal digestive systemExocrine pancreatic insufficiency, or EPI, is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas.

What is the pancreas?

The pancreas is a glandular organ in the digestive system and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, somatostatin, and pancreatic polypeptide, and a digestive organ, secreting pancreatic juice containing digestive enzymes that assist the absorption of nutrients and the digestion in the small intestine. These enzymes help to further break down the carbohydrates, proteins, and lipids in the chyme.

Pancreatic insufficiency is when the pancreas is not producing enough enzymes for proper digestion. Pancreatic insufficiency  typically occurs as a result of progressive pancreatic damage that may be caused by recurrent acute pancreatitis or by chronic pancreatitis due to a variety of conditions.”

EPI Symptoms

Common symptoms of pancreatic insufficiency include malabsorption, malnutrition, vitamin deficiencies and weight loss. Other symptoms are steatorrhea (loose, fatty, foul-smelling stools), gas and bloating, pain, abdominal tenderness, loss of appetite or feeling of fullness, and diarrhea. Those with pancreatic insufficiency also may be prone to bruising or suffer from bone pain, muscle cramps or night blindness.

Severe EPI

Severe pancreatic insufficiency occurs in such diseases as cystic fibrosis, chronic pancreatitis and surgeries of the gastrointestinal system. Certain GI diseases, such as stomach ulcers, celiac disease and Crohn’s disease, and autoimmune disorders, such as system lupus erythematosus, may contribute to the development of pancreatic insufficiency.

Chronic pancreatitis develops over several years after many attacks of acute pancreatitis and may cause you to lose the ability to secrete the enzymes your body needs to digest foods. Pancreatic insufficiency is a common cause of chronic pancreatitis.

Acute Pancreatitis

Acute pancreatitis is caused by excessive alcohol consumption and gallstones, as well as viral and bacterial infections, drugs, blockage of the pancreatic duct, trauma or surgery to the abdomen, elevated calcium levels or very high triglyceride levels.

EPI Treatment

Treatment for pancreatic insufficiency includes dietary and lifestyle changes, and vitamin supplements. Consuming a low-fat diet is recommended to help prevent the steatorrhea that often accompanies pancreatic insufficiency.

Additionally, because alcoholism is one of the main causes of pancreatitis, it is recommended that you abstain from drinking. Since smoking increases the risk of pancreatic cancer and pancreatitis, quitting is essential.

Part of the course of treatment also may be to replace digestive enzymes, using supplements made from a pig pancreas, according to Peace Health. Other treatments include taking pain-relieving medications or NSAIDs (nonsteroidal anti-inflammatory drugs), or narcotic painkillers if the pain is severe enough.

How To Prevent EPI

According to experts, adding enzymes to your meals, taking antioxidants, eating a low-fat diet and getting routine checkups may help prevent pancreatic insufficiency.

EPI 101 was originally published on

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