• Exocrine pancreatic insufficiency (EPI) occurs when the pancreas doesn’t make enough enzymes to break down food.
  • Enzyme supplements can treat EPI.
  • People with EPI have higher rates of cancer, heart disease, and malnutrition, which can affect life expectancy.

Exocrine pancreatic insufficiency (EPI) occurs when the pancreas doesn’t make enough enzymes to break down food.

Enzymes play an important role in the digestion of food. When you eat, the pancreas releases enzymes to digest fats, proteins, and carbohydrates. Some enzymes are also present in saliva, the stomach, and the small intestine.

Specific enzymes digest specific nutrients. Fats, proteins, and carbohydrates each have a unique enzyme that breaks them down. Without the right type and amount of these enzymes, your body can’t get nutrients from your food.

It’s possible to manage EPI with enzyme replacement therapy.

In its early stages, EPI can be overlooked. Symptoms may be similar to other gastrointestinal conditions.

People with EPI have a greater risk for malnutrition, which can affect life expectancy. Malnutrition can result from the poor absorption of nutrients, which can be a part of EPI.

Also, sometimes EPI makes it hard to eat enough because of pain or other symptoms.

People with EPI also have a greater risk for developing cardiovascular disease and diabetes.

In one 8-year study, 10 percent of people with chronic pancreatitis — a common cause of EPI — experienced a cardiovascular event, such as a heart attack, stroke, or signs of cardiovascular disease. Most of these people also had EPI.

It’s important to have regular contact with your EPI healthcare team. Let them know if you notice any changes in your health.

The pancreas is a small organ located just behind the stomach. It releases a variety of enzymes to digest food.

The pancreas also contains the cells that make insulin. Pancreatitis is when the pancreas becomes inflamed. Sometimes this happens for a short period. Other times, it’s ongoing, or chronic.

Inflammation damages the pancreas over time, preventing it from working properly.

Chronic pancreatitis is a common cause of EPI. Diagnosing pancreatitis in its early stages can improve your outlook.

Signs of pancreatitis include:

  • pain in the upper abdomen that may get worse after eating
  • diarrhea
  • oily-looking stool
  • nausea or vomiting
  • unexplained weight loss

Pancreatitis can cause malnutrition. The pain and digestive symptoms of pancreatitis can make it harder to get enough to eat. Even if you can eat enough, your body can’t access nutrients from food without the right amount of enzymes.

Like EPI, pancreatitis increases the risk of diabetes.

A 2014 Danish study compared people with chronic pancreatitis with the general population. It found that people with chronic pancreatitis lived an average of 8 years less than the general population.

According to the study, pancreatic cancer was the most common reason for increased likelihood of death.

Keep in mind that there are many individual variables that affect someone’s life expectancy. One study’s findings won’t translate to your personal outlook.

The main treatment for EPI is enzyme supplementation. Pancreatic enzyme replacement therapy is also known as PERT.

With PERT, you take enzymes with each of your meals and snacks. It may take some time to figure out the right dose. Often, taking enzyme supplements with the first bite of the meal is best. Sometimes, an additional dose of enzyme supplements is added partway through the meal.

Medications called proton pump inhibitors may be helpful too. They reduce the amount of acid in the stomach and can make PERT more effective.

Fat is the nutrient that relies on pancreatic enzymes the most for digestion. Some people find their symptoms are better with a low fat diet.

A low fat diet is not recommended for everyone, though. It makes it hard to get enough nutrients and calories. The goal is to be able to eat as balanced a diet as possible. Enzyme supplements can be adjusted to get enough nutrition while preventing symptoms.

Vitamins A, D, E, and K are fat-soluble vitamins. This means they need fat sources to be properly absorbed in the body.

With a low fat diet or fat malabsorption, many people with EPI are low in these vitamins. You may need to supplement these vitamins to make sure you’re getting enough.

Alcohol intake can worsen inflammation in the pancreas. If you drink alcohol, try reducing your alcohol consumption or avoiding it completely.

Smoking cigarettes can make pancreatitis worse, too, and speed up damage to the pancreas. If you smoke, do your best to cut down or quit. Consider reaching out to your doctor for help.

EPI occurs when the pancreas doesn’t make enough enzymes. It can happen as a result of chronic pancreatitis.

Your body needs enzymes to digest and absorb nutrients from food. Untreated EPI can lead to digestive symptoms and malnutrition.

Enzyme supplements treat EPI. If you smoke cigarettes or drink alcohol, it’s recommended to quit smoking and reduce alcohol. These can worsen pancreatitis.