Exocrine pancreatic insufficiency, or EPI, is a condition that affects the pancreas — an organ in the abdomen that plays a vital role in helping the body digest food and manage blood sugar levels. One way the pancreas supports the digestive system is by producing enzymes that help break down food.
“People develop EPI when these enzyme-producing cells of the pancreas are damaged or destroyed,” explains Mustafa Raoof, M.D., M.S., a surgical oncologist at City of Hope® Cancer Center Duarte who specializes in treating diseases including pancreatic cancer, liver, bile duct and other gastrointestinal cancers. “Common causes of EPI can include chronic pancreatitis, cystic fibrosis and pancreatic tumors.”
While EPI is not cancer and does not cause cancer, the condition is commonly found in patients diagnosed with pancreatic cancer.
In this article, Dr. Raoof covers the basics on EPI, answering questions including:
- What is exocrine pancreatic insufficiency?
- Is EPI a sign of cancer?
- What are the most common EPI symptoms?
- How is EPI diagnosed?
- How is EPI treated?
If you or a loved one has been diagnosed with pancreatic cancer or another type of cancer and you are looking for a second opinion, call us 24/7 at 877-460-4673.
What Is Exocrine Pancreatic Insufficiency?
Exocrine pancreatic insufficiency occurs when the pancreas does not make enough enzymes to help the body digest food or is unable to deliver these enzymes effectively. EPI is most often related to other health issues affecting the pancreas, including:
- Chronic pancreatitis, which is long-term inflammation of the body’s pancreatic tissue and the most common cause of EPI
- Pancreatic tumors, including both benign (noncancerous) and malignant (cancerous) tumors
- Cystic fibrosis, a genetically inherited condition that affects the lungs and digestive system
“EPI is extremely common among pancreatic cancer patients, affecting 60% to 90% of patients depending on the stage and tumor location,” says Dr. Raoof.
Is EPI a Sign of Cancer?
EPI is not a sign of cancer. However, pancreatic cancer may cause EPI.
“While EPI does not cause cancer, pancreatic tumors frequently cause EPI by physically blocking the pancreatic duct or destroying healthy pancreatic tissue,” says Dr. Raoof.
Because EPI and pancreatic cancer may cause similar symptoms, patients who experience signs or symptoms of either condition should see their primary care doctor as soon as possible.
What Are the Most Common EPI Symptoms?
The most common symptoms of EPI are digestive issues such as:
- Greasy or oily stool (steatorrhea)
- Unexplained weight loss
- Diarrhea
- Gas, indigestion or bloating
- Severe abdominal cramping
There are also several known risk factors for developing EPI. These include:
- Having obesity
- Being a smoker
- Drinking excessive amounts of alcohol
- A history of chronic pancreatitis
How Is EPI Diagnosed?
Elastase is one of the digestive enzymes produced in the pancreas. It helps break down the fats in our food.
“Doctors usually diagnose EPI using a simple stool test called a fecal elastase test,” Dr. Raoof says. “We may also recommend blood tests that check for fat-soluble vitamin deficiencies.”
The results of these tests may help determine whether the pancreas is working normally or if it is not producing the enzymes necessary to help digest fats, carbohydrates and proteins.
How Is EPI Treated?
“The standard treatment for EPI is called pancreatic enzyme replacement therapy, or PERT,” says Dr. Raoof. “PERT involves taking prescription pills that contain lipase, protease and amylase.”
Other tools for treating EPI include making dietary changes and taking supplements that ensure a patient is receiving the vitamins, minerals and other nutrients he or she needs to support healthy digestion.
If you or a loved one has been diagnosed with pancreatic cancer or another type of cancer and you are looking for a second opinion, call us 24/7 at 877-460-4673.