Problems with the pancreas can cause exocrine pancreatic insufficiency (EPI). Symptoms can be similar to those of several other digestive conditions and include bloating, gas, pain, and fatty stools.
The pancreas plays an important role in digestion. It produces enzymes that help break down carbohydrates, fat, and protein, allowing the body to get the nutrients it needs to function.
Damage to the cells that produce these pancreatic enzymes can cause EPI. In people with the condition, the pancreas does not produce enough enzymes for the body to break down food and absorb nutrients.
Without treatment, the condition can lead to several
In people with EPI, the body does not break down carbohydrates, proteins, and fats in foods into substances that it can absorb. As a result, undigested and unabsorbed food remains in the digestive tract, which can lead to a number of uncomfortable gastrointestinal symptoms.
The symptoms of EPI are generally nonspecific. In other words, a person or their doctor
Steatorrhea refers to excess fat in the stool. It is the
A doctor can test for excess fat in the stool using a
- oily or greasy
- hard to flush
Although EPI often causes steatorrhea, there are other possible causes, including medication side effects.
Other symptoms of EPI
People with EPI may experience unexplained weight loss because the body cannot absorb nutrients. They may also experience nutritional deficiencies, particularly of the fat-soluble vitamins A, D, E, and K.
Other common digestive symptoms of EPI include:
- abdominal pain
- excess gas
It is important to note that these symptoms do not necessarily mean that a person has EPI. Other conditions can also produce these symptoms. A person should speak with a doctor if they develop persistent gastrointestinal symptoms or suspect that something may be wrong.
The pancreas plays an important role in digestion. When functioning normally, it releases several different enzymes.
The enzymes that the pancreas secretes
Causes and risk factors for EPI
Several underlying conditions can cause or put a person at higher risk of developing EPI.
Other common causes and risks factors associated with EPI include:
- heavy alcohol use
- acute pancreatitis
- autoimmune pancreatitis
- benign pancreatic tumor
- pancreatic cancer
- cystic fibrosis
- Shwachman–Diamond syndrome
- pancreatic neoplasms after surgery
Treatment goals for EPI include improving the quality of life for the person and preventing complications associated with the condition, such as malnutrition.
The most common treatment involves the use of replacement enzymes known as pancreatic enzyme replacement therapy (PERT). PERT involves taking medications with every meal and snack to aid digestion and prevent symptoms from occurring.
A person should follow all instructions from their doctor or pharmacist when taking PERT. Some common advice includes:
- avoiding taking the medication on an empty stomach
- taking the medication toward the start of a meal after the first few bites
- eating a diet consisting of fruits, lean proteins, vegetables, and whole grains
- including fats in the diet
- eating smaller, more frequent meals
- taking the medication with a cool drink rather than a hot beverage
- discussing new medications, supplements, and vitamins with a doctor before starting them
- talking with a doctor about side effects
A person should talk with a doctor if they experience ongoing or distressing digestive symptoms. If the cause is not EPI, a doctor may find another underlying condition that they can address.
People living with chronic pancreatitis should keep an eye out for symptoms such as oily stool, excess gas, and other digestive issues. If these symptoms occur, they should talk with a doctor about the possibility of EPI.
A person undergoing treatment for EPI should seek medical advice if:
- they experience side effects
- their symptoms do not improve
- they are considering taking a new medication or supplement
EPI causes nonspecific digestive symptoms that several other conditions can also cause. The most common symptom is excess fat in the stool, which can cause it to be loose, oily, and more odorous than usual.
A person should talk with a doctor about any ongoing or unusual symptoms. The symptoms may not be the result of EPI, but a doctor can help determine the underlying cause.
If EPI is the cause, treatment with PERT can manage the symptoms and reduce the risk of complications.