Who gets EPI?

Exocrine pancreatic insufficiency (EPI) is associated with certain diseases and conditions that affect the pancreas. Some of these diseases you are born with, like cystic fibrosis, while others may occur later in life, as is the case with chronic pancreatitis.

EPI may be associated with the following diseases and conditions. If you have one of these conditions and symptoms of EPI, take the EPI Symptom Checker and talk to your doctor.

  • Chronic pancreatitis

    Chronic pancreatitis (CP) is the most common cause of EPI in adults. CP is a chronic inflammatory disease of the pancreas. Over time the inflammation can lead to irreversible damage to the pancreas, including the cells that secrete pancreatic digestive enzymes and the cells that produce insulin, leading to diabetes. There are different causes of CP, including alcohol abuse, genetic mutations, long history of smoking, and blockage of the pancreatic duct.

  • Cystic fibrosis

    Cystic fibrosis (CF) is an inherited genetic condition that leads to chronic disease that mainly affects the lungs and digestive and reproductive systems. In patients with CF, a thick, sticky mucus is produced in certain organs throughout the body, most commonly in the lungs and digestive system, including the pancreas. Many people living with CF are unable to properly digest food because they may also have EPI.

  • Pancreatectomy

    Pancreatectomy is the medical term for the surgical removal of the pancreas. The surgery may involve removal of the entire pancreas (total pancreatectomy) or only a portion of the pancreas (partial pancreatectomy). A pancreatectomy can be performed as a treatment for pancreatic cancer, pancreatic tumors (pre-malignant), chronic pancreatitis, or when the pancreas has been severely damaged by injury. Removing part of or the entire pancreas may cause a loss of pancreatic digestive enzyme production, leading to EPI.

  • Pancreatic cancer

    Cancer of the pancreas may cause damage to the pancreas, leading to EPI. Pancreatic cancer is sometimes treated with a pancreatectomy.

  • Gastrointestinal surgery

    Certain surgeries on the stomach and intestines may affect how the enzymes that your pancreas makes digest the food you eat.

  • Diabetes

    Diabetes is a disease of the endocrine part of the pancreas. People with diabetes have trouble producing or using insulin, a hormone that helps control blood sugar. Some people with diabetes may also have EPI.

  • Other conditions

    There are other less common conditions associated with EPI. Talk to your doctor if you have symptoms; only he or she can determine if you have EPI.

  • Chronic pancreatitis

    Chronic pancreatitis (CP) is the most common cause of EPI in adults. CP is a chronic inflammatory disease of the pancreas. Over time the inflammation can lead to irreversible damage to the pancreas, including the cells that secrete pancreatic digestive enzymes and the cells that produce insulin, leading to diabetes. There are different causes of CP, including alcohol abuse, genetic mutations, long history of smoking, and blockage of the pancreatic duct.

  • Cystic fibrosis

    Cystic fibrosis (CF) is an inherited genetic condition that leads to chronic disease that mainly affects the lungs and digestive and reproductive systems. In patients with CF, a thick, sticky mucus is produced in certain organs throughout the body, most commonly in the lungs and digestive system, including the pancreas. Many people living with CF are unable to properly digest food because they may also have EPI.

  • Pancreatectomy

    Pancreatectomy is the medical term for the surgical removal of the pancreas. The surgery may involve removal of the entire pancreas (total pancreatectomy) or only a portion of the pancreas (partial pancreatectomy). A pancreatectomy can be performed as a treatment for pancreatic cancer, pancreatic tumors (pre-malignant), chronic pancreatitis, or when the pancreas has been severely damaged by injury. Removing part of or the entire pancreas may cause a loss of pancreatic digestive enzyme production, leading to EPI.

  • Pancreatic cancer

    Cancer of the pancreas may cause damage to the pancreas, leading to EPI. Pancreatic cancer is sometimes treated with a pancreatectomy.

  • Gastrointestinal surgery

    Certain surgeries on the stomach and intestines may affect how the enzymes that your pancreas makes digest the food you eat.

  • Diabetes

    Diabetes is a disease of the endocrine part of the pancreas. People with diabetes have trouble producing or using insulin, a hormone that helps control blood sugar. Some people with diabetes may also have EPI.

  • Other conditions

    There are other less common conditions associated with EPI. Talk to your doctor if you have symptoms; only he or she can determine if you have EPI.

  • Chronic pancreatitis

    Chronic pancreatitis (CP) is the most common cause of EPI in adults. CP is a chronic inflammatory disease of the pancreas. Over time the inflammation can lead to irreversible damage to the pancreas, including the cells that secrete pancreatic digestive enzymes and the cells that produce insulin, leading to diabetes. There are different causes of CP, including alcohol abuse, genetic mutations, long history of smoking, and blockage of the pancreatic duct.

  • Cystic fibrosis

    Cystic fibrosis (CF) is an inherited genetic condition that leads to chronic disease that mainly affects the lungs and digestive and reproductive systems. In patients with CF, a thick, sticky mucus is produced in certain organs throughout the body, most commonly in the lungs and digestive system, including the pancreas. Many people living with CF are unable to properly digest food because they may also have EPI.

  • Pancreatectomy

    Pancreatectomy is the medical term for the surgical removal of the pancreas. The surgery may involve removal of the entire pancreas (total pancreatectomy) or only a portion of the pancreas (partial pancreatectomy). A pancreatectomy can be performed as a treatment for pancreatic cancer, pancreatic tumors (pre-malignant), chronic pancreatitis, or when the pancreas has been severely damaged by injury. Removing part of or the entire pancreas may cause a loss of pancreatic digestive enzyme production, leading to EPI.

  • Pancreatic cancer

    Cancer of the pancreas may cause damage to the pancreas, leading to EPI. Pancreatic cancer is sometimes treated with a pancreatectomy.

  • Gastrointestinal surgery

    Certain surgeries on the stomach and intestines may affect how the enzymes that your pancreas makes digest the food you eat.

  • Diabetes

    Diabetes is a disease of the endocrine part of the pancreas. People with diabetes have trouble producing or using insulin, a hormone that helps control blood sugar. Some people with diabetes may also have EPI.

  • Other conditions

    There are other less common conditions associated with EPI. Talk to your doctor if you have symptoms; only he or she can determine if you have EPI.

Sources: 1. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011:4:55-73. 2. Keller J, Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(suppl VI):vi1-vi28. 3. Yadav D, Hawes RH, Brand RE, et al. Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis. Arch Intern Med. 2009;169:1035-1045. 4. Surgery for pancreatic cancer. American Cancer Society website. http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-treating-surgery. Updated June 11, 2014. Accessed September 22, 2014. 5. Sah RP, Chari ST. Autoimmune pancreatitis: an update on classification, diagnosis, natural history and management. Curr Gastroenterol Rep. 2012;14(2):95-105. 6. Friedman S, Blumberg RS. Inflammatory bowel disease. In: Longo DL, Fauci AS, Kasper DL, et al, eds. Harrison's Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012.