When you have exocrine pancreatic insufficiency (EPI), your body will let you know. The condition happens when your pancreas doesn’t make the enzymes you need to digest food. Without them, you won’t get enough important vitamins and nutrients from your diet. That can lead to a few classic signals of the condition.

You might feel or notice:

  • You’re losing weight without trying. It’s a common symptom of EPI.
  • Greasy, foul-smelling stools that float or are tough to flush. It’s a sign your body isn’t absorbing fat from your diet like it should.    
  • Diarrhea.
  • Stomach cramps. You may be bloated, too.
  • Bad-smelling gas. When you don’t absorb food well, bacteria can grow in your intestine and release smelly gases.
  • Swelling in your lower legs.
  • Skin that’s pale, bruises easily, or gets rashes.

You might not have all of these symptoms, but you should let your doctor know what you’ve been feeling.

More Clues

Besides its outward symptoms, EPI also affects your body in ways you can’t always see or feel.

When you don’t absorb fat and other nutrients from food well, your body can be low on vitamins A, D, E and K. Without them, you could become less able to see at night or in low light, a condition called night blindness. You could also get bone diseases like osteopenia. EPI can also lead to anemia, in which your blood doesn’t have enough healthy red blood cells.

In severe cases, your bones could break easily, and you might get muscle spasms or cramps or have seizures. When you don’t get enough vitamins and nutrients from your food, you could also have problems with walking and balance. You could also notice weakness or numbness in your hands and feet.

Gut Advice

If you have EPI, your doctor will suggest treatments that can help. He can also recommend other ways to improve your digestion. If you’re not getting better, let him know.

WebMD Medical Reference

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.
Jane C., 62
Phoenix, AZ
It’s easy to feel isolated with food restrictions. I eat before we go so I’m not hungry and tempted to eat something that may make me sick. With family or close friends, I bring my own meal. They’re happy to let me heat it up, and it takes pressure off them.
Roberta L., 63
Santa Ana, CA
It's not always easy, but a positive attitude really helps. Find a quote, write it down, and carry it with you. When things get tough, read it. My favorite is: Fate whispers to the warrior, ‘You cannot withstand the storm.’ The warrior whispers back, ‘I am the storm.
Liz J., 32
San Francisco
Some days are better than others -- and symptom severity can be influenced by our mental health and how we relate to the pain and discomfort. Meditation and deep breathing exercises have gotten me through some pretty intense episodes.

From WebMD

More on EPI