Exocrine pancreatic insufficiency (EPI) is a condition that happens when there’s a problem with your pancreas, mainly with how well it helps you digest food.

Your pancreas makes enzymes that break down the fats, proteins, and starches you eat so your body can use them. If the organ can’t do its job, you can have digestive and other problems, such as:

  • Loss of appetite
  • Diarrhea
  • Weight loss
  • Loose, pale, oily, foul-smelling stools
  • Stomach pain
  • Gas and bloating
  • Bone pain
  • Muscle cramps

Without treatment, EPI can make you malnourished -- you won't get enough important vitamins and nutrients from your diet -- and it can lead to other serious conditions, such as thinning bones (osteoporosis) or the blood condition anemia.

Who’s at Risk?

EPI starts in people who have a damaged pancreas or a health condition that keeps the organ from working as it should. You might be at risk if you have:

  • Surgery on your stomach, pancreas, or gallbladder
  • A disorder that affects your pancreas, like cystic fibrosis, Shwachman-Diamond syndrome, or pancreatic cancer
  • Stomach ulcers
  • Celiac disease

If you’re on a low-fat diet for a pancreas-related condition, you might have EPI but no symptoms.

Chronic Pancreatitis

This is the most common cause of EPI in adults. It happens when the pancreas has been inflamed for a long time. This can damage the organ and its enzymes. Heavy alcohol use and smoking cause chronic pancreatitis, but some types of it also run in families.

Cystic Fibrosis

In this genetic disorder, your body makes a thick, sticky mucus that can block the pancreas and keep it from releasing enzymes. If you have cystic fibrosis, your doctor might want to test you for EPI. It’s especially important to get pancreas problems diagnosed in children because they need the right amount of nutrients and vitamins to grow. 

Next Steps

If you think you might have EPI, talk to your doctor. She may send you to a doctor who treats stomach diseases, called a gastroenterologist. This specialist will test you and recommend treatments that can help.

WebMD Medical Reference

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WebMD Voices

Matt E., 58
Sinking Spring, PA
If you're newly diagnosed, take comfort in knowing it typically takes weeks, if not months, to get your diet and enzyme dosing dialed in to where EPI symptoms may be under control. Don't get too worried by bad days early on.
Jane C., 62
Phoenix, AZ
'No alcohol' goes without saying. If you're socializing, try virgin drinks or simple club soda and lime. Fluid intake is important. I don't go anywhere without my water bottle. I drink coffee on good mornings, tea in the evening, and ginger ale on tough days.
Roberta L., 63
Santa Ana, CA
When you're away from home, it’s good to know where restrooms are. There are apps out there like Sit or Squat and Flush. You put in your location and it gives you the nearest bathrooms. Keep or carry an extra set of clothes in case of emergency.
Joe V., 79
Winneconne, WI
Look for a good support system -- friends, family, other survivors. Keeping positive people around you helps you get through the tougher days. It's important to remain hopeful. I'm a 14-year pancreatic cancer survivor. A positive attitude and keeping my faith helps.

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