- Exocrine pancreatic insufficiency (EPI) occurs when the pancreas doesn’t make enough enzymes.
- Chronic pancreatitis is a risk factor for both EPI and pancreatic cancer.
- Without the right treatment, EPI can cause malnutrition.
Exocrine pancreatic insufficiency (EPI) occurs when your pancreas doesn’t make enough enzymes. Enzymes are an essential part of digesting food. The pancreas — a small organ behind the stomach — is where most of the body’s enzymes are made and released when you eat.
There are different enzymes for each nutrient. Fats, proteins, and carbohydrates each have specific enzymes.
EPI prevents you from properly digesting your food. This can lead to malnutrition.
EPI can cause several digestive symptoms and pain. Some of these symptoms can be similar to other conditions.
Many different things can cause EPI. Sometimes people have EPI as a result of pancreatic cancer. EPI itself doesn’t lead to cancer.
The link between pancreatic cancer and EPI is chronic pancreatitis. Chronic pancreatitis involves ongoing inflammation in the pancreas that starts to cause damage. This damage can be a risk factor for developing EPI or pancreatic cancer.
Pancreatic cancer can cause EPI. In fact, the rate of people with pancreatic cancer who develop EPI is
EPI could also be caused by a tumor blocking the release of enzymes.
It’s important to diagnose EPI early. Malnutrition is common in pancreatic cancer. Pancreatic enzyme replacement therapy (PERT) plays an important role in improving nutritional status.
For a variety of reasons, EPI may be undertreated in people with pancreatic cancer. A 2018 analysis showed that people with pancreatic cancer on PERT lived longer compared to those who did not take PERT. This was true for any stage of pancreatic cancer.
The biggest risk of EPI is malnutrition. If you don’t have the right type and numbers of enzymes, you can’t get the nutrients from your food. Symptoms of EPI, including pain, can also reduce appetite, making your risk of malnutrition worse.
Pancreatic enzyme replacement therapy (PERT) can treat EPI. The goal of PERT is to allow you to eat as normal a diet as possible to get the nutrients you need.
Chronic pancreatitis increases the risk of other conditions, like heart disease, cancer, and diabetes. It’s important to monitor your health and let your healthcare professional know about any changes.
EPI can be a sign of pancreatic cancer. There are also other causes, so having EPI doesn’t mean you have pancreatic cancer.
Chronic pancreatitis is one of the main causes of EPI. Chronic pancreatitis is associated with a higher risk of cancer, especially pancreatic cancer.
In a large Danish study, 13.6 percent of people with chronic pancreatitis developed cancer, with pancreatic cancer being the most common type. This is compared to 7.9 percent of the control group.
There have been multiple studies looking at the rates of EPI in pancreatic cancer.
A 2015 review included people with pancreatic cancer who were not surgically treated. It reported that 50 to 100 percent of them had EPI.
In people with pancreatic cancer, PERT improves nutritional status. People who received PERT lived longer compared to those who didn’t get PERT in a 2018 study.
The symptoms of EPI come from the lack of enzymes to digest your food.
Symptoms of EPI include:
- nausea and vomiting
- oily stool that floats and may be hard to flush
- stool that’s a pale color
- pain in the upper abdomen, especially after you eat
Diagnosing EPI can be tricky. Many of the digestive symptoms can be similar to other conditions.
Fat in the stool is more likely to occur in EPI than with other conditions. If you naturally eat less fat because of digestive trouble, you may not have fatty stools. If you notice any change in your digestion, it’s smart to talk with your doctor.
Malnutrition is common in EPI. When you can’t absorb nutrients from your food, some of these problems can also occur:
- unexplained weight loss
- anemia, related to iron or B12 deficiency
- osteopenia or osteoporosis, related to low vitamin D levels
- problems with blood not clotting properly, related to low vitamin K status
EPI happens because of a lack of enzymes to break down food. EPI doesn’t cause cancer but is sometimes a sign of pancreatic cancer. Pancreatic cancer and EPI are more likely to occur in a person with chronic pancreatitis.
The symptoms of EPI can be similar to other digestive conditions. Treatment for EPI involves pancreatic enzyme supplements.
It’s important to talk with your doctor if you notice any changes in your digestive health.