How EPI Is Treated

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Exocrine pancreatic insufficiency is a condition where, the body's pancreas is not producing the enzymes it needs to help break down foods. In turn, they can have various symptoms such as bloating, abdominal discomfort, foul-smelling stools, and in more severe cases, weight loss. Because the pancreas is not producing the enzymes it needs to break down foods, they can have what's called malabsorption. And in turn, this can lead to malnutrition where the body is not absorbing its nutrients.

Many of the digestive diseases that we treat have overlapping symptoms. And these symptoms are nonspecific and can be manifestations of many of the other conditions. It would be really difficult to differentiate whether the symptoms they're experiencing are due to EPI or one of the other conditions. It's important therefore, that they go to seek medical advice from their primary care physician or a specialist like a gastroenterologist to have appropriate testing done.

EPI is treated by replacing the enzymes that the pancreas is not able to produce. It typically consists of three
amylase, which is used to break down starches; lipase, which is used to break down fats; and protease, which is used to break down proteins. This is commonly referred to as PERT or pancreatic enzyme replacement therapy. And it's typically available in tablet or capsule form and contains varying amounts of lipase, protease, and amylase.

The dose is adjusted based on one's weight and degree of pancreatic insufficiency. Patients take the pancreatic enzyme replacement therapy with each meal or snack. We typically have patients take the capsules at the beginning of their meal. If the meal is going to last 20 minutes or longer, we recommend that they take half at the beginning of the meal and half of it half of the way through. For snacks, we have them take half of the dose of the medication. In patients who have exocrine pancreatic insufficiency, they have a difficult time breaking down fats.

They therefore, can become deficient in fat soluble vitamins and these are vitamins A, D, E, and K. It's important that patients speak to their medical professionals so that they can have these labs checked to see if they're deficient in it and then replace it by taking supplements. It's important that they eat small, frequent, high-caloric meals to allow their body to digest these foods better and absorb the nutrients properly. It's important that they modify their behavior. So if they're drinking alcohol in excess, it's important to moderate or stop completely. They should stop smoking and they should eat a whole food, high calorie, nutrient-rich diet.