Exocrine Pancreatic Insufficiency (EPI)

*Please note: This slide set represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.

The pancreas is an important organ in the digestive system.

The pancreas has two functions: endocrine and exocrine.

Its endocrine function is to produce the hormones that regulate blood sugar, such as insulin.

Its exocrine function is to produce enzymes that help us break down our food so that we can absorb their nutrients.

Exocrine pancreatic insufficiency, or EPI, occurs when the pancreas becomes damaged and is no longer able to produce enough digestive enzymes to properly digest food, particularly fat and protein.

Consequently, people with EPI fail to get nutrition from the food they eat, even if they are eating a balanced diet.

Malabsorption leads to malnutrition and deficiencies in vitamins and minerals.

This can lead to nutrition-related disease such as weak bones, vision problems, easy bruising, and skin rashes. Some people may also have difficulty gaining or maintaining their weight.

Many also have common gastric disturbances (such as diarrhea, bloating, flatulence) and steatorrhea, which is stool that is oily, yellow-streaked, foul-smelling and difficult to flush.

EPI occurs mainly in people who have chronic pancreatitis or an inherited condition that affects the exocrine pancreas, like cystic fibrosis.

EPI is diagnosed using a combination of tests including testing the stool for fat, testing the stool for an enzyme made by the pancreas called fecal elastase, and sometimes stimulating the pancreas with medications to see if it makes the proper amount of hormones.

Since there is no cure for EPI, treatment focuses on managing the symptoms of the disease.

Patients are advised to follow a healthy low-fat diet and avoid high fat foods. They are also prescribed pancreas enzyme replacement therapy (or PERT), vitamins and mineral supplements.

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Slide Show - Exocrine Pancreatic Insufficiency (EPI)
This slide focuses on exocrine pancreatic insufficiency, or EPI, which occurs when the pancreas becomes damaged and is no longer able to produce enough digestive enzymes to properly digest food.

Also Available in this Section

Animation - Understanding Nutrition and the Role and Benefits of PERT
This animation describes pancreatic enzyme replacement therapy (PERT) and it’s role and benefit for patients who have exocrine pancreatic insufficiency (EPI). The animation provides an overview of the role of pancreatic enzymes in food digestion, the different types of PERT medications that are currently available, and provides tips for dosing and timing of PERT. For the majority of patients taking PERT, there is a significant improvement of symptoms, nutritional status, and overall quality of life.
Watch now
Animation - Exocrine Pancreatic Insufficiency (EPI)
This animation focuses on exocrine pancreatic insufficiency, or EPI, which occurs when the pancreas becomes damaged and is no longer able to produce enough digestive enzymes to properly digest food.
Watch now
Expert Video - What are the causes and symptoms of exocrine pancreatic insufficiency (EPI)?
Physicians discuss EPI, including causes, risk factors and long-term consequences like nutrition-related diseases. They also discuss inherited conditions that are linked to EPI.
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Expert Video - How is EPI diagnosed?
Physicians discuss how they diagnose EPI, including lifestyle factors and symptoms that lead them to suspect EPI, and the follow-up tests that confirm the diagnosis.
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Expert Video - How is EPI treated?
Physicians discuss the approaches to treating EPI including pancreatic enzyme replacement therapy (PERT), vitamin and mineral supplementation, and dietary interventions. They also discuss when they decide to implement PERT.
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Patient Video - EPI symptoms did you experience? How was your EPI diagnosed?
Patients with acute pancreatitis describe the symptoms they experienced that led them to their diagnosis of EPI.
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Patient Video - What is your experience with pancreatic enzymes?
Patients discuss their personal experiences and treatment plans for EPI.
Watch now
Slide Show - Understanding Nutrition and the Role and Benefits of PERT
This slide show describes pancreatic enzyme replacement therapy (PERT) and it’s role and benefit for patients who have exocrine pancreatic insufficiency (EPI). The animation provides an overview of the role of pancreatic enzymes in food digestion, the different types of PERT medications that are currently available, and provides tips for dosing and timing of PERT. For the majority of patients taking PERT, there is a significant improvement of symptoms, nutritional status, and overall quality of life.
Watch now

This educational activity has been developed by: The National Pancreas Foundation and Mechanisms in Medicine Inc.

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This website is part of the Animated Patient™ series that provides highly visual formats of learning for patients to improve their understanding, make informed decisions, and partner with their health care professionals for optimal outcomes.