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6 Exocrine Pancreatic Insufficiency Symptoms That Can Cause GI Trouble

When you develop funky digestive symptoms like diarrhea or stomach pain, it’s easy to give the side-eye to more commonly discussed gastrointestinal (GI) conditions like irritable bowel syndrome or celiac disease. And for good reason: For most people dealing with these types of symptoms, there’s usually a well-known explanation behind them.

But exocrine pancreatic insufficiency (EPI) can be a sneaky force that wreaks havoc on your GI tract—it’s just usually underdiagnosed. Never heard of EPI before? You’re not alone. Exocrine pancreatic insufficiency doesn’t get as much airplay as other GI issues, but it can still cause plenty of misery when you’re on the quest for answers.

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  IdentifyEPI.com

Once diagnosed, EPI is a manageable condition when treated with pancreatic enzyme replacement therapy (PERT) as part of an EPI management plan.

 Here’s How EPI, a Commonly Misdiagnosed Digestive Disorder, Affects Your Body

Exocrine pancreatic insufficiency can spur all sorts of side effects that take a toll on your life.

Articles of Interest

Practical guide to exocrine pancreatic insufficiency – Breaking the myths

Many diagnostic tests are available to diagnose EPI, however, the criteria of choice remain unclear and the causes for a false-positive test are not yet understood. Despite multiple studies on the treatment of EPI using exogenous pancreatic enzymes, there remains confusion amongst medical practitioners with regard to the best approach to diagnose EPI, as well as dosing and administration of pancreatic enzymes.

State of the Art in Exocrine Pancreatic Insufficiency

This review offers an in-depth overview of EPI in order to support the proper management of this entity based on updated and integrated knowledge of its etiopathogenesis, prevalence, diagnosis, and treatment.

What is Exocrine Pancreatic Insufficiency (EPI)?

Exocrine Pancreatic Insufficiency (EPI) occurs when the pancreas does not secrete enough digestive enzymes and is common in people with chronic pancreatitis. This is because as the pancreas gets scarred, the part of the pancreas that generates enzymes is destroyed. As a result, the pancreas is unable to produce these enzymes that are essential to digest food. If you suffer from EPI, your body has difficulties breaking down food.

A Primer on Exocrine Pancreatic Insufficiency, Fat Malabsorption, and Fatty Acid Abnormalities

Exocrine pancreatic insufficiency (EPI) is characterized by a deficiency of exocrine pancreatic enzymes, resulting in deficits in digestion of all macronutrients, with deficiencies in digestion of fats being the most clinically relevant.

Can you see what makes EPI unique?

Diagnosing Exocrine Pancreatic Insufficiency (EPI) can be a challenge if your patients don’t open up about their GI symptoms. But with the right questions, you can get what you need for a diagnosis.

Diagnosis and treatment of pancreatic exocrine insufficiency

Pancreatic exocrine insufficiency (PEI) can be defined as a reduction in pancreatic enzyme activity in the intestinal lumen to a level that is below the threshold required to maintain normal digestion. This concept is crucial for the understanding of PEI and has several important consequences for the diagnosis and treatment of this condition.

Exocrine Pancreatic Insufficiency in Type 1 and Type 2 Diabetes

Type 1 and type 2 diabetes are often accompanied by mostly mild forms of exocrine pancreatic insufficiency. Despite high prevalence, little is known about the clinical consequences of exocrine pancreatic insufficiency and its optimal (nutritional) treatment.

Exocrine pancreatic insufficiency: prevalence, diagnosis, and management

Exocrine pancreatic insufficiency (EPI) is a condition caused by reduced or inappropriate secretion or activity of pancreatic juice and its digestive enzymes, pancreatic lipase in particular. EPI can result in clinical manifestation and biochemical alterations causing reduced quality of life and life-threating complications.

Gut Check: Drs Brian Lacy and Santhi Vege on Exocrine Pancreatic Insufficiency

And today we're going to be discussing a topic that comes up frequently during office visits with any provider who is evaluating a patient with chronic diarrhea. And the question is, is the diarrhea due to pancreatic insufficiency?

Less common etiologies of exocrine pancreatic insufficiency

Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases (diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin (CCK); celiac or inflammatory bowel disease (IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery...

Steve Jobs' Illness Offers Complex Mystery

Whatever else Apple CEO Steve Jobs is accomplishing by his cryptic health statements, he's stimulating a lot of public education about such obscure maladies as pancreatic insufficiency and glucagonomas.

Understanding Exocrine Pancreatic Insufficiency (EPI)

EPI is diagnosed based on a combination of patient history, symptoms and specific laboratory tests. The symptoms of EPI can be similar to other digestive conditions — which can complicate the process of diagnosing it.

What You Should Know About Exocrine Pancreatic Insufficiency (EPI) or Pancreatic Exocrine Insufficiency (PEI)

It took a long time for me to get diagnosed (almost 2 years), so this post walks through my history and testing process with my gastroenterologist (GI doctor) and the importance of knowing your own body and advocating for yourself when something is wrong or not quite right.

Resources

5 Questions to Ask Your Doctor After an Exocrine Pancreatic Insufficiency Diagnosis

The condition can cause all sorts of mayhem in the digestive tract.

Exocrine Pancreatic Insufficiency

These are some of the posts that I’ve written about EPI (also known as PEI) that might be of use to anyone else with EPI. There’s not a lot of information written and targeted at patients, and there’s also gaps in the medical literature and research studies regarding optimal titration of enzymes (known as Pancreatic Enzyme Replacement Therapy, or PERT). I spent some time figuring out how to optimally dose and titrate PERT and other enzyme sources, essentially developing a method for creating a lipase:fat and protease:protein ratio for better dosing enzymes.

Loma Linda Health

Because a patient may not experience steatorrhea until after the pancreas loses 90 percent of enzyme production, it can be difficult to diagnose EPI. Physicians may rule out other, more common conditions before giving an EPI diagnosis.

StatPearls

The pancreas has an essential role in the digestion, absorption, and metabolism of carbohydrates, fats, and proteins. Damage to the cells producing pancreatic enzymes leads to exocrine pancreatic insufficiency, which is a serious problem leading to malnutrition, complications, and poor quality of life.