What is exocrine pancreatic insufficiency (EPI)?

What is exocrine pancreatic insufficiency (EPI)?

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Enzymes stimulate chemical reactions in the body. The enzymes produced in the pancreas move into the small intestine, where they help break down food so that it can be absorbed into the body. Exocrine pancreatic insufficiency, or EPI, occurs when the pancreas does not produce enough enzymes to break down food and absorb the nutrients. 


Exocrine pancreatic insufficiency is rare but usually results from diseases and conditions that affect the pancreas, primarily pancreatitis and cystic fibrosis . Even less common is EPI caused by surgery on the pancreas, stomach, or intestines.

Symptoms and Diagnosis

The first symptoms of EPI are usually indigestion and changes in bowel movements as a result of gas from malabsorption. As EPI continues, additional problems can show up from the body not having all the nutrients and nourishment it needs.

Laboratory tests of the blood and stool are the first step in confirming a diagnosis.


Pancreatic enzymes can be given as pills or granules to replace what the body isn't making  This is call PERT or pancreatic enzyme replacement therapy to improve digestion and absorption. Special vitamin supplements are often needed as well.