Conditions associated with EPI

Exocrine pancreatic insufficiency (EPI) is associated with certain diseases and conditions that affect the pancreas1

EPI may be associated with the following diseases and conditions2-12:

CHRONIC PANCREATITIS (CP)
CYSTIC FIBROSIS (CF)
OTHER CONDITIONS
  • Obstruction of the biliary or pancreatic duct
  • Pancreatic cancer
  • Previous pancreatic surgery
    (partial resection or total pancreatectomy)
  • Diabetes mellitus (type I and type IIIC)
References: 1. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 2. Bures J. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2978. 3. Cavalot F, Bonomo K, Fiora E, et al. Does pancreatic elastase-1 in stools predict steatorrhea in type 1 diabetes? Diabetes Care. 2006;29(3):719-721. 4. Etemad B, Whitcomb DC. Chronic pancreatitis: diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. 5. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26 Suppl 1:S5-S20. 6. Hahn J-U, Kerner W, Maisonneuve P, Lowenfels AB, Lankisch PG. Low fecal elastase 1 levels do not indicate exocrine pancreatic insufficiency in type-1 diabetes mellitus. Pancreas. 2008;36(3):274-278. 7. Hardt PD, Hauenschild A, Jaeger C, et al. High prevalence of steatorrhea in 101 diabetic patients likely to suffer from exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations: a prospective multicenter study. Dig Dis Sci. 2003;48(9):1688-1692. 8. Keller J. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(suppl_6):1-28. 9. Matsumoto J, Traverso LW. Exocrine function following the whipple operation as assessed by stool elastase. J Gastrointest Surg. 2006;10(9):1225-1229. 10. Witt H, Apte MV, Keim V, Wilson JS. Chronic pancreatitis: challenges and advances in pathogenesis, genetics, diagnosis, and therapy. Gastroenterology. 2007;132(4):1557-1573. 11. Yuasa Y, Murakami Y, Nakamura H, et al. Histological loss of pancreatic exocrine cells correlates with pancreatic exocrine function after pancreatic surgery. Pancreas. 2012;41(6):928-933. 12. Czakó L, Hegyi P, Rakonczay Z, Wittmann T, Otsuki M. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology. 2009;9(4):351-359.