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<p><strong>In this section:</strong></p>
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<ul>
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<li><a href="#whatisepi">What is EPI?</a></li>
|
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<li><a href="#howcommonepi">How common is EPI?</a></li>
|
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<li><a href="#likelyepi">Who is more likely to have EPI?</a></li>
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<li><a href="#complicationsepi">What are the complications of EPI?</a></li>
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</ul>
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<h2 id="whatisepi">What is EPI?</h2>
|
||
<p>Exocrine pancreatic insufficiency (EPI) is a condition in which your <a href="/Dictionary/S/small-intestine" class="dictionary-term">small intestine</a> can’t digest food completely because of problems with digestive <a href="/Dictionary/E/enzyme" class="dictionary-term">enzymes</a> from your pancreas. EPI often develops slowly, over many years.</p>
|
||
<p>The pancreas is a large <a href="/Dictionary/G/gland" class="dictionary-term">gland</a> behind your <a href="/Dictionary/S/stomach" class="dictionary-term">stomach</a>. The pancreas is both</p>
|
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<ul>
|
||
<li>an <a href="/Dictionary/E/endocrine-gland" class="dictionary-term">endocrine gland</a> that makes <a href="/Dictionary/H/hormone" class="dictionary-term">hormones</a></li>
|
||
<li>an <a href="/Dictionary/E/exocrine-gland" class="dictionary-term">exocrine gland</a> that makes digestive juice containing enzymes</li>
|
||
</ul>
|
||
<p>The pancreas delivers the digestive juice to the small intestine through a single duct. In the small intestine, the enzymes from the pancreas help digest food, breaking down <a href="/Dictionary/C/carbohydrates" class="dictionary-term">carbohydrates</a>, <a href="/Dictionary/F/fat" class="dictionary-term">fats</a>, and <a href="/Dictionary/P/protein" class="dictionary-term">proteins</a>.</p>
|
||
<p>You may develop EPI if</p>
|
||
<ul>
|
||
<li>the amount of enzymes your pancreas makes is severely reduced</li>
|
||
<li>not enough enzymes reach your small intestine</li>
|
||
<li>other problems prevent the enzymes from mixing with food or otherwise working well</li>
|
||
</ul>
|
||
<div><span class="figure fill center"><a title="View full-sized image" class="expand" href="/-/media/Images/Health-Information/Digestive-Diseases/pancreas-illustration_1586x1534.jpg" target="_blank"></a><img height="1534" alt="The size and location of the pancreas in the body. An inset shows the pancreatic duct emptying into the small intestine." width="1586" src="/-/media/Images/Health-Information/Digestive-Diseases/pancreas-illustration_1586x1534.jpg" /><span class="figcaption"><span class="caption">The pancreas is a large gland that makes digestive juice containing enzymes.</span></span></span></div>
|
||
<h2 id="howcommonepi">How common is EPI?</h2>
|
||
<p>EPI is rare. However, problems with enzymes from the pancreas occur more often in people with certain <a href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/symptoms-causes#whatcausesepi">health conditions</a>.</p>
|
||
<p>Although study results vary, experts think problems with enzymes from the pancreas may occur in<sup>1</sup></p>
|
||
<ul>
|
||
<li>30% to 90% of people with <a href="/Dictionary/C/chronic" class="dictionary-term">chronic</a> <a href="/health-information/digestive-diseases/pancreatitis">pancreatitis</a></li>
|
||
<li>80% to 90% of people with <a href="https://medlineplus.gov/cysticfibrosis.html">cystic fibrosis</a></li>
|
||
</ul>
|
||
<p>Less commonly, problems with enzymes in the pancreas may occur in people who have</p>
|
||
<ul>
|
||
<li><a href="https://www.cancer.gov/types/pancreatic">pancreatic cancer</a> that has not been removed by surgery</li>
|
||
<li><a href="/health-information/diabetes/overview/what-is-diabetes/type-1-diabetes">type 1 diabetes</a> or <a href="/health-information/diabetes/overview/what-is-diabetes/type-2-diabetes">type 2 diabetes</a></li>
|
||
<li><a href="/Dictionary/I/inflammatory-bowel-disease" class="dictionary-term">inflammatory bowel disease</a></li>
|
||
<li>untreated <a href="/health-information/digestive-diseases/celiac-disease">celiac disease</a></li>
|
||
<li>surgery of the pancreas or <a href="/Dictionary/U/upper-GI-tract" class="dictionary-term">upper gastrointestinal tract</a></li>
|
||
<li><a href="https://www.niams.nih.gov/health-topics/sjogrens-syndrome">Sjogren’s syndrome</a></li>
|
||
<li>a history of smoking or drinking alcohol</li>
|
||
</ul>
|
||
<h2 id="likelyepi">Who is more likely to have EPI?</h2>
|
||
<p>People who have advanced pancreatic diseases are more likely to develop EPI. For example, EPI is more common in people who have</p>
|
||
<ul>
|
||
<li>chronic and <a href="/Dictionary/A/acute" class="dictionary-term">acute</a> pancreatitis</li>
|
||
<li>cystic fibrosis</li>
|
||
<li>pancreatic cancer</li>
|
||
<li>surgery of the pancreas or upper gastrointestinal tract</li>
|
||
</ul>
|
||
<h2 id="complicationsepi">What are the complications of EPI?</h2>
|
||
<p>In EPI, the small intestine doesn’t digest food as it should and may not absorb enough nutrients—a condition called <a href="/Dictionary/M/malabsorption" class="dictionary-term">malabsorption</a>. EPI and malabsorption can lead to complications such as</p>
|
||
<ul>
|
||
<li><a href="/Dictionary/M/malnutrition" class="dictionary-term">malnutrition</a></li>
|
||
<li>low levels of fat-soluble <a href="https://medlineplus.gov/definitions/vitaminsdefinitions.html">vitamins</a> A, D, E, and K in the body</li>
|
||
<li>low <a href="https://medlineplus.gov/bonedensity.html">bone mass</a>, called osteopenia, and <a href="https://medlineplus.gov/osteoporosis.html">osteoporosis</a></li>
|
||
<li>problems with growth in children</li>
|
||
<li>weakness of the <a href="/Dictionary/I/immune-system" class="dictionary-term">immune system</a></li>
|
||
<li>increased risk of cardiovascular events, such as <a href="https://medlineplus.gov/heartattack.html">heart attack</a> and <a href="https://medlineplus.gov/stroke.html">stroke</a></li>
|
||
</ul>
|
||
<h2>Reference</h2>
|
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<aside class="references">
|
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<p id="1">[1] Capurso G, Traini M, Piciucchi M, Signoretti M, Arcidiacono PG. <a href="https://pubmed.ncbi.nlm.nih.gov/30962702/">Exocrine pancreatic insufficiency: prevalence, diagnosis, and management</a>. <em>Clinical and Experimental Gastroenterology</em>. 2019;12:129–139. doi:10.2147/CEG.S168266</p>
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