What is Exocrine Pancreatic Insufficiency?
Exocrine pancreatic insufficiency (EPI) interferes with digestion. Your pancreas does not produce enough enzymes for your body to break down and absorb nutrients.
Enzymes help to accelerate chemical reactions in your body. The enzymes produced by your pancreas travel to your small intestine, where they aid in the digestion of the food you ingest.
You don't get enough nourishment if you have EPI because your body can't absorb fats, vitamins, and minerals from food. You may lose weight or get abdominal pain.
There are medications that work for the majority of individuals and provide you with a new supply of enzymes, allowing you to resume proper digestion of food.
Aside from taking medication, you can manage your symptoms by eating the correct foods. Your doctor will advise you on foods that will provide you with the nutrients and protein that you may be lacking.
SYMPTOMS OF EXOCERINE PANCREATIC INSUFFICIENCY
Because EPI makes it more difficult for your body to digest food, you will experience symptoms that are similar to those of other digestive diseases. Among the symptoms are:
1. Bloating
When bacteria in your stomach ferment unabsorbed food, they produce hydrogen and methane, which causes gas and bloating. Bloating can make your stomach appear larger than usual and make you feel "full."
2. Stomach pain
Abdominal pain or discomfort occurs when partially digested food must move through the digestive system. Food that has been fully digested is more easily absorbed by the digestive system and hence causes little to no pain.
3. Diarrhea
When your digestive system fails to break down lipids and other nutrients, extra water enters the colon, resulting in watery stools. Diarrhea can be extremely painful and cause dehydration.
4. Steatorrhea
Steatorrhea is characterized by greasy, colorless, bulky, foul-smelling, and difficult-to-flush stools. This is a common side effect of severe EPI.
Fatty stools develop when the pancreas' fat digesting enzymes fall below 5 to 10% of normal levels. This means that your digestive system excretes a large portion of the fat you consume rather than absorbing it. Steatorrhea isn't always obvious, especially if you limit your fat intake since it causes digestive issues.
5. Weight loss
EPI can cause weight loss even if you eat a normal amount of food. This occurs when your body does not break down food into smaller forms that your digestive system can use. You may also lose weight if you eat less to prevent the unpleasant symptoms of EPI.
6. Vitamin and nutrition deficiency 
Pancreatic enzymes normally break food down into little molecules that your body may absorb into the bloodstream. When EPI inhibits the digestive system's ability to break down food, the body is unable to utilize those nutrients and vitamins.
Fat and protein absorption are major dietary issues associated with EPI. You may also be deficient in vitamins A, D, E, and K because excess fat in your digestive tract absorbs the vitamins, which are subsequently excreted from your body along with the fat.
Malnourishment can cause symptoms such as muscle weakness and a loss of body weight. Deficits in vitamins can also lead to visual difficulties, osteoporosis, and muscle weakness.
Diagnosis Process for Exocrine Pancreatic Insufficiency
The three most common EPI tests used to aid in diagnosis are:
1. Fecal elastase test: This test determines the amount of elastase, a pancreatic enzyme, in your feces. Elastase insufficiency may be a sign of EPI. This test may make it more difficult to diagnose milder EPI.
2. Fecal fat test: The amount of fat in your stool is determined by this test. This test might help you figure out how much fat your body isn't absorbing. It may also indicate signs of steatorrhea (foul-smelling, oily stools). Some people find this test difficult because it requires following a predetermined diet as well as collecting and processing feces samples over a three-day period.
3. Pancreatic function test: This type of test is thought to be the most accurate approach to examine your pancreas' exocrine function. A catheter is inserted into your small intestine to collect pancreatic secretions. This test is often performed only at specialized facilities, and its use is limited.
TAKEAWAY
If you've been diagnosed with EPI, keep in mind that it's a treatable illness if you follow your doctor's or gastroenterologist's suggestions. Pancreatic enzyme replacement treatment may be included (PERT).
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