6 Questions to Ask Your Doctor After an Exocrine Pancreatic Insufficiency Diagnosis

byAIT BENNACER • • 2 min read
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 6 Questions to Ask Your Doctor After an Exocrine Pancreatic Insufficiency Diagnosis

6 Questions to Ask Your Doctor After an Exocrine Pancreatic Insufficiency Diagnosis

What is the cause of my exocrine pancreatic insufficiency (EPI)?

Exocrine Pancreatic Insufficiency (EPI) is a condition in which the pancreas is unable to produce enough enzymes to properly digest food. The most common cause of EPI is chronic pancreatitis, but it can also be caused by other conditions such as cystic fibrosis, Shwachman-Diamond syndrome, pancreatic cancer, or the removal of a large portion of the pancreas. EPI can also be caused by certain medications, such as those used to treat diabetes and cystic fibrosis. In some cases, the cause of EPI may be unknown. Your doctor will be able to provide more specific information about the cause of your EPI based on your medical history and test results. 
What treatment options are available for EPI?

Treatment options for exocrine pancreatic insufficiency (EPI) include:

  1. Pancreatic enzyme replacement therapy (PERT): This involves taking oral supplements that contain enzymes to help digest food. These enzymes are usually taken before meals to help break down fats, proteins, and carbohydrates.
  2. Diet modification: A dietitian may recommend a low-fat diet and avoiding high-fiber foods to help reduce symptoms.
  3. Vitamin supplementation: EPI can lead to deficiencies in certain vitamins, such as vitamin B12, which may require supplementation.
  4. Treating underlying cause: If an underlying condition such as cystic fibrosis or chronic pancreatitis is causing EPI, it is essential to treat that condition to help reduce symptoms.
  5. Surgery: Surgery may be required in some cases such as pseudocyst or cancer.

How often will I need to have my EPI symptoms monitored?

The frequency of monitoring for exocrine pancreatic insufficiency (EPI) symptoms will depend on the underlying cause of your condition and the effectiveness of your treatment plan.

If you are taking pancreatic enzyme replacement therapy (PERT) and your symptoms are well controlled, your doctor may only need to see you for follow-up appointments every few months.

If you have an underlying condition such as cystic fibrosis or chronic pancreatitis that is causing your EPI, your doctor may want to see you more frequently to monitor the progression of that condition and make adjustments to your treatment plan as needed.

If you are experiencing complications such as malabsorption, your doctor may want to see you more frequently to monitor your weight, vitamin levels, and overall health.

Are there any dietary restrictions or recommendations I should follow? 

If you have been diagnosed with exocrine pancreatic insufficiency (EPI), your doctor or a dietitian may recommend certain dietary changes to help manage your symptoms. These may include:

  1. Low-fat diet: EPI can make it difficult for your body to digest fats. A low-fat diet can help reduce symptoms such as diarrhea, abdominal pain, and weight loss.
  2. Avoiding high-fiber foods: High-fiber foods can be difficult to digest if you have EPI. Your doctor or dietitian may recommend avoiding foods high in fiber, such as raw fruits and vegetables, nuts, and whole grains.
  3. Taking enzymes with meals: If you are taking pancreatic enzyme replacement therapy (PERT), it is important to take the enzymes with meals to help digest food properly.
  4. Eating smaller, more frequent meals: EPI can make it difficult to digest large meals. Eating smaller, more frequent meals throughout the day can help reduce symptoms.
  5. Drinking fluids between meals: Drinking fluids during meals can dilute the enzymes that help digest food. It is best to drink fluids between meals.
  6. Avoiding alcohol and tobacco: Alcohol and tobacco can worsen symptoms of EPI and also cause damage to the pancreas. 
Are there any potential complications from EPI that I should be aware of?

  •  Malnutrition: EPI can make it difficult for your body to absorb the nutrients it needs from food, leading to malnutrition and weight loss.
  • Vitamin deficiencies: EPI can lead to deficiencies in certain vitamins, such as vitamin B12 and fat-soluble vitamins (A, D, E, and K).
  • Steatorrhea (excess fat in stool): EPI can cause the body to excrete undigested fat in the stool, leading to diarrhea and large, greasy, foul-smelling stools.
  • Anemia: EPI can lead to anemia due to the malabsorption of iron, vitamin B12, and folate.
  • Pancreatic cancer: EPI can occur as a complication of pancreatic cancer, which is a serious condition that requires prompt treatment.
  • Pancreatic pseudocyst: EPI can be associated with the formation of pseudocyst which may require surgical intervention.

Are there any clinical trials or new treatments for EPI that I may be eligible for?
Exocrine Pancreatic Insufficiency (EPI) is a rare condition, and as a result, there are not many clinical trials for this condition specifically. However, some ongoing clinical trials are investigating new treatments for EPI and other conditions that may cause EPI as a complication.
It's important to note that the availability of clinical trials and the eligibility criteria for these trials can vary depending on the location and stage of the study. Some clinical trials may require participants to have specific characteristics, such as a certain stage of the disease or a specific genetic condition.
  • Investigating new forms of pancreatic enzyme replacement therapy (PERT)
  • Investigating new ways to deliver PERT, such as through a nasal spray or inhaler
  • Investigating new drugs that can help protect the pancreas from damage
  • Investigating new surgical procedures for conditions that can cause EPI, such as chronic pancreatitis
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