Exocrine Pancreatic Insufficiency – EPI

The digestive system produces enzymes to help your body break down food and absorb nutrients. The pancreas is a key component of this system, producing many of those important enzymes.

When the pancreas doesn’t make, or deliver, the appropriate amount of enzymes, Exocrine Pancreatic Insufficiency (EPI) can occur.

Patients who are diagnosed with this disease often have trouble digesting food resulting in maldigestion. We’re talking all about this disease, risk factors, triggers and potential treatments on this blog.

Risk Factors

EPI can occur at any point in your life, sometimes as an effect of a condition you were born with, like cystic fibrosis. Cystic fibrosis most commonly affects the cells that produce mucus, sweat and digestive fluids by creating a thick or sticky substance. This substance can create blockages in the pancreas, preventing it from distributing the digestive enzymes and prohibiting digestion. The disease can also occur after a long-term illness like chronic pancreatitis. In this example, inflammation is usually the cause. Chronic inflammation can lead to organ stress or damage, including the cells that produce digestive fluids. Diabetes, Celiac’s Disease, Autoimmune Pancreatitis and even Pancreatic Cancer can also be associated with EPI.


Diagnosing EPI can be challenging, as many of the symptoms can also be caused by other diseases such as Celiac’s disease or Crohn’s disease. You might experience changes in stools, weight loss, and/or digestive discomfort and could experience several symptoms or one singular symptom. Your doctor can work to determine what is causing your distress by ordering some tests, including bloodwork and fecal tests. Through bloodwork, your doctor can assess your nutrient and vitamin levels, identifying any areas that are low which could indicate that your body is unable to absorb these things as expected. Fecal tests typically look for elastase and fat content. Two of the biggest EPI triggers (when not caused by a pre-existing condition) are fatty foods because they are naturally tough to break down, and extended alcohol use which can lead to inflammation and pancreatitis.


Pancreatic Enzyme Replacement Therapy is one way to treat EPI by replacing the enzymes that your body is missing, and helping aid in digestion. Anti-inflammatories can be helpful for patients with pancreatitis, and they also assist in reducing discomfort. Your doctor may recommend vitamins or supplements to replenish any depleted areas and maintain proper nutrient levels. Prescription medication may also be prescribed to manage your symptoms. Limiting alcohol consumption, and eating a diet high in nutritional value but low in fat content  may also help ease EPI symptoms by making digestion easier and lowering inflammation.

While there is no cure for EPI, there are several treatment options available. The Great Lakes Gastroenterology staff is available to talk through symptoms and treatment options through in-person and virtual visits.

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