The major hormonal stimulus that causes pancreatic digestive enzyme secretion is the release of cholecystokinin from the duodenum.
Bicarbonate alkalinizes intraluminal duodenal pH and prevents inactivation of digestive pancreatic enzymes.
“Normal” amount of pancreatic enzyme secretion varies with content and volume of meal ingested.
Normal pancreatic enzyme secretion varies3
480,000Lipase units per meal
720,000Lipase units per meal (Average)
960,000Lipase units per meal
EPI may result in:
Digestion is not clearly impaired until enzyme output has been decreased to ≤10% of normal. EPI impairs the breakdown of nutrients. In EPI, the digestion of fat is the most impaired.
Malabsorption of nutrients including fat-soluble vitamins (A, D, E, and K) may accompany EPI.
Symptoms of EPI are mostly related to insufficient pancreatic enzymes leading to undigested and unabsorbed fat reaching the colon and being excreted in feces (steatorrhea). Other symptoms of EPI include frequent diarrhea, unexplained weight loss, flatulence and bloating, and abdominal pain.
See how symptoms overlap with
other GI conditions