5 Symptoms of Exocrine Pancreatic Insufficiency ( EPI)

Stomach enzymes from the pancreas help digest meals. These little portions absorb well. This starts when you bite. This process slows and fails if the pancreas is injured or has a condition such chronic pancreatitis, alcoholism, or another illness. EPI develops when the pancreas does not generate adequate digestive hormones.

Digestion issues result from exocrine pancreas dysfunction. This prevents nutritional absorption, causing constipation, weight loss, and malnutrition.

EPI is connected to Crohn's, ulcerative colitis, celiac, diabetes, and chronic pancreatitis. Epidemiological studies discovered this link. GI surgery, particularly pancreatic or stomach resection, puts patients at danger.

Lupus and irritable bowel syndrome are linked to EPI.

If you have any of these conditions, watch for EPI signs.

What is Exocrine Pancreatic Insufficiency (EPI)?

Simply put, EPI refers to a lack of exocrine pancreatic function. When the pancreas fails to produce enough digestive enzymes, the Exocrine pancreatic insufficiency occurs. In some cases, enzymes fail to function normally.

Proteins called enzymes catalyze several biochemical processes. Enzymes present in the digestive tract helps our body to absorb nutrients from the food. EPI is most common in those with chronic pancreatitis, particularly older adults, and in children with cystic fibrosis.

What exactly brings on EPI, or Exocrine Pancreatic Insufficiency?

The pancreas functions in the digestion process. It produces digestive enzymes that improve food absorption. Insufficient digestive enzyme production characterizes EPI. More of the food you eat makes it through your digestive system undigested. This is because the body is not getting enough of nutrients from the food particles that is required by the body.

Pancreatic enzymes have a variety of forms, such as

  • Carbohydrate-digesting amylase.

  • The fat-digesting enzyme lipase.

  • Proteinases and elastases are enzymes that digest other proteins.

EPI Symptoms

EPI can be hard to diagnose for both you and your doctor since its symptoms are so similar to those of other, more common digestive disorders and syndromes. Experiencing several of these signs suggests EPI may be at blame.

Diarrhea, loss of appetite, and intolerance to fatty foods are classic symptoms of exocrine pancreatic insufficiency.

The most prevalent EPI signs are listed below.

1. Diarrhea

When food remains unprocessed in the small intestine, it might cause diarrhea due to EPI. Inability to absorb lipids and other nutrients results from a lack of pancreatic enzyme production. They don't pass through the large intestine and cause diarrhea; rather, they stay put and cause dehydration.

2. Slimming Down

You can lose weight if your body has trouble digesting fats and nutrients. People who simultaneously suffer with another digestive disorder, such Crohn's disease, are more likely to have this.

3. Steatorrhea

Steatorrhea is characterized by the passage of greasy stools due to the passage of fat that has not been absorbed by the body. If a person has exocrine pancreatic insufficiency, they will have floating, oily feces after eating fatty foods since the fat isn't absorbed.

4. Stomach Ache

The discomfort is typically dull or severe and located in the upper right abdomen.

5. Symptoms that aren't related to the Gut

Vitamin deficits can cause non-digestive symptoms if you can't absorb these nutrients.

Exocrine pancreatic insufficiency patients often lack iron, B12, folate, and calcium. Fat-soluble vitamins A, D, E, and K may be deficient if you have difficulties digesting fat. Fat digestion issues might cause vitamin loss. Vitamin insufficiency causes a raised, scaly rash. Night blindness, muscular cramps, paresthesia, and easy bruising may also occur.

Cystic fibrosis and pancreatitis—two common pancreatic injuries—have distinct symptoms.

Your primary care physician should check you and propose next actions if you're suffering digestive symptoms that sound like EPI.

How can one identify EPI, or Exocrine Pancreatic Insufficiency?

Symptoms of EPI can be caused by a wide variety of digestive disorders. If your healthcare professional notices that you have a pancreatic problem, they may think that you have EPI.

The following pancreatic function tests may be administered to you −

  • Protein digestion aiding elastase enzyme can be detected in feces with the elastase enzyme test (FE-1). EPI may be present if elastase levels are low.

  • A fecal fat analysis can determine how much fat is present in the feces. EPI has been linked to increased fat mass.

  • The secretin pancreatic function test measures digestive enzyme production by monitoring the pancreas' reaction to secretin. The test involves intravenous (IV) administration of secretin. Your doctor may draw fluid for an enzyme test using endoscopic ultrasonography.

  • Imaging tests such as a CT scan or ultrasound of the abdomen may also be performed. Pancreatic issues that can lead to EPI can be detected with these exams.


Your family physician may prescribe you a gastroenterologist for further if he or she cannot determine the cause of your digestive issues. EPI symptoms may be alleviated itself can be treated, by using of pancreatic enzymes along with some vitamin supplements.

Updated on: 05-May-2023


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