An overview of exocrine pancreatic insufficiency

The pancreas is responsible for producing and supplying enzymes that help digest food. However, in exocrine pancreatic insufficiency (EPI), the pancreas is unable to generate adequate amounts of enzymes that the body requires to break down food and absorb nutrients. This condition develops slowly, so one might not notice the symptoms right away. As the condition progresses, it triggers symptoms such as abdominal pain, gas, diarrhea, feeling full, and foul-smelling stools. Additionally, one might experience weight loss and nutritional deficiencies because of the body’s inability to absorb the essential vitamins and minerals.

Damage to the pancreas can lead to exocrine pancreatic insufficiency. One of the common causes of EPI is chronic pancreatitis. This occurs when the enzymes created by the pancreas start functioning while they are still inside it instead of moving to the small intestine. The risk of chronic pancreatitis is amplified if one is into heavy drinking. However, immune system disorders, inflammation of the pancreatic passageways, and high amounts of triglycerides can also cause exocrine pancreatic insufficiency. Likewise, surgery on the intestines, pancreas, or stomach, and inherited diseases like cystic fibrosis and Shwachman-Diamond syndrome can also contribute to the development of EPI. In rare cases, digestive disorders such as celiac and Crohn’s disease can also induce this disorder.

To diagnose the condition, the doctor will conduct a full physical examination and inquire about the symptoms. If they suspect EPI, they will order for blood and stool exam along with a CT scan, an MRI, or an endoscopic ultrasound.

If the test results for exocrine pancreatic insufficiency are positive, the doctors will implement the Pancreatic Enzyme Replacement Therapy (PERT) to manage the symptoms and prevent further damage. The patient will have to take prescription pills that supply the small intestine with the enzymes required for digesting food and absorbing the nutrients. These are supposed to be taken while one is having meals so that the replacement enzymes can break down food in an efficient and timely manner.

Patients who are dealing with abdominal pain may also have to take pain relievers. Even over-the-counter painkillers should be taken only after consulting with the doctor so that they don’t negatively interact with the PERT drugs. The medications used in PERT might cause side effects such as diarrhea, constipation, and nausea, so one should discuss the possible pros and cons of the medicines with their doctor, especially if they are already dealing with some kind of health condition.

Along with PERT, one should also adopt a healthy diet to manage the symptoms of exocrine pancreatic insufficiency. It can be confusing to pick the right foods, so one can speak to a dietician or to their physician. Eating small 6 to 7 meals instead of 3 heavy meals throughout the day will be a better option as it will not strain the digestive system. Likewise, one should ensure that they abstain from alcohol as it can make it harder for the body to retain fat and gradually damage the pancreas. Patients might also have to take vitamin supplements until the body regains its strength.

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