Exocrine pancreatic insufficiency (EPI) occurs when the pancreas doesn’t make or release enough of the enzymes needed to break down food and absorb nutrients.

If you have EPI, figuring out what to eat can be tricky. You need to make sure you’re getting enough nutrients and vitamins, but you also need to avoid foods that irritate your digestive tract.

On top of this, some conditions associated with EPI, like cystic fibrosis, Crohn’s disease, Celiac disease, and diabetes, have additional special dietary requirements.

Fortunately, a balanced diet combined with enzyme replacement therapy can help ease your symptoms and improve your quality of life.

Here are some tips and recommendations to keep in mind if you have EPI.

Eat a varied diet

Since your body has difficulty absorbing nutrients, it’s extra important that you choose foods with a balanced mix of:

  • proteins
  • carbohydrates
  • fats

A diet rich in vegetables and fruits is a great place to start.

Seek out minimally processed foods

Cooking from scratch will help you avoid processed foods and deep fried foods, which often contain hydrogenated oils that’ll be hard for you to digest.

Stay hydrated

Drinking enough water will help your digestive system run smoothly. If you have diarrhea caused by EPI, it’ll also prevent dehydration.

Plan ahead

Planning ahead for meals and snacks on the go will make it easier to avoid foods that aggravate your digestive system.

EPI and fats

In the past, doctors recommended that people with EPI eat a low-fat diet. This is no longer the case because your body needs fats to absorb certain vitamins.

Avoiding fat can also make weight loss associated with EPI more severe. Taking enzyme supplements allows most people with EPI to eat a diet with normal, healthy fat levels.

When choosing meals, remember not all fats are created equal. Make sure you’re getting enough essential fats. Avoid highly processed foods and those high in trans fat, hydrogenated oils, and saturated fat.

Instead look for foods that contain:

  • monounsaturated fat
  • polyunsaturated fat
  • omega-3 fatty acids

Olive oil, peanut oil, nuts, seeds, and fish, such as salmon and tuna, all contain healthy fats.

Fiber-rich foods

While eating lots of fiber is typically associated with a healthy diet, if you have EPI, too much fiber can interfere with enzyme activity.

Foods like brown rice, barley, peas, and lentils are higher in fiber. Certain breads, and carrots are lower in fiber.


Years of heavy alcohol use can increase your likelihood of pancreatitis and EPI. Reduce your chances of further damaging your pancreas by limiting your alcohol intake.

The recommended daily alcohol limit for women is one drink and for men, it’s two drinks.

Avoid eating large meals

Eating large meals makes your digestive system work overtime. You’re less likely to have uncomfortable symptoms of EPI if you eat small portions three to five times per day, as opposed to having three large meals.

Certain vitamins are more difficult for your body to absorb when you have EPI. It’s important to talk to your doctor about which supplements are right for you.

Your doctor may prescribe vitamin D, A, E, and K supplements to prevent malnutrition. These should be taken with meals in order for them to be absorbed properly.

If you’re taking enzyme replacements for your EPI, they should also be taken during every meal to avoid malnutrition and other symptoms. Talk to your doctor if enzyme replacement therapy isn’t working.

If you have questions about your diet, consider consulting with a registered dietitian. They can teach you how to cook healthy, affordable meals that work for your dietary needs.

If you have conditions related to EPI, such as diabetes, cystic fibrosis, or inflammatory bowel disease, working with a dietitian can help you find a meal plan that fits all of your health needs.

While these tips serve as a starting point, it’s important to work with your doctor or a dietitian to create a plan tailored to your specific needs and conditions.

Everyone has different food tolerances. If your diet isn’t working for you, talk to your doctor or dietitian about other options.