Exocrine Pancreatic Insufficiency

Exocrine Pancreatic Insufficiency
We diagnosed a patient this week with Exocrine Pancreatic Insufficiency. He presented
with abdominal pain, gas, and diarrhea.
Exocrine pancreatic insufficiency (EPI) is a medical condition brought about by deficiency of pancreatic enzymes that are important to help with the breakdown of food so it can be absorbed.
These enzymes include amylase which is responsible for the breakdown of carbohydrates, lipase which breaks down fats, and both protease and elastase which break down proteins. The most common cause of EPI in adults is chronic pancreatitis as this condition damages the pancreatic cells that make digestive enzymes. This often occurs from chronic alcohol or tobacco use. Symptoms of EPI also include abdominal bloating, diarrhea, and unexplained weight
loss. 
Pancreas functioning tests are used to diagnose EPI. One option is the fecal elastase test, which measures the amount of elastase in the patient’s stool sample. Absence or minimal amounts of this digestive enzyme indicate EPI. Another option is the fecal fat test to measure the amount of fat in the stool. A high fat volume suggests a diagnosis of EPI. Lastly, various imaging tests, such as a CAT scan, may also be used to better visualize the pancreas and reveal any
abnormalities.
While EPI is a chronic condition that requires lifelong management, there are treatments available. Treatment for EPI focuses on ensuring the patient is receiving sufficient nutrients. The most common treatment is a prescription medication called pancreatic enzyme replacement therapy (PERT) that serves as a substitute for digestive enzymes. Once adequate medications are started, patients are usually able to resume a normal diet and their symptoms disappear.
For further information you can make an appointment at .

References:

Cleveland Clinic. “Exocrine Pancreatic Insufficiency (EPI): Pancreatitis.” Cleveland Clinic, 10
June 2021, my.clevelandclinic.org/health/diseases/21577-exocrine-pancreatic-
insufficiency-epi.

Olivia Fanuele, M.A. and Michael Kushner, M.D.