An EPI patient
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Eating healthy, nutritious meals is important for everyone, but if you’re living with EPI, it’s essential. If you have EPI, your pancreas cannot properly break down foods, resulting in poor digestion of the 3 main nutrients you need for energy—protein, carbohydrates, and especially fats. Your doctor or nutritionist can help you maintain the nutrition you need and manage gastrointestinal symptoms.

How does EPI affect digestion?

To help digestion with EPI, eating more frequently (incorporating 2-3 snacks along with 3 main meals daily) is recommended.* If you’ve been prescribed a PERT (pancreatic enzyme replacement therapy), it should be taken with all meals and snacks as part of your diet for EPI. 

Staying hydrated with at least 8 glasses of fluid every day is also important to help prevent dehydration, which can impact people with EPI.

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What foods should I eat with EPI?

You may think all fats should be avoided when managing EPI, but that’s not true. Including fat as part of a well-balanced diet is necessary for nutrition, to absorb fat-soluble vitamins (A, D, E, and K). Since fat is not being properly absorbed in your body when you have EPI, it’s important to work with your doctor to determine the right balance of fat in your diet based on your EPI treatment plan.

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Are there certain foods to avoid with EPI?

In general, highly processed foods are harder for your body to digest (with or without EPI), which are commonly found in microwaveable meals, meat products, and breakfast cereals. Consult with your doctor or nutritionist for individual dietary recommendations as part of your overall EPI management plan.

*The diet recommendations provided on are not intended for people with EPI due to cystic fibrosis, who may have very different and specific nutritional needs.

What else is important for my EPI diet and lifestyle?

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Vitamins and supplements

With EPI, getting all the vitamins you need may take more than just eating well. To maintain proper levels of the fat-soluble vitamins A, D, E, and K, your doctor may prescribe vitamin supplements. Take as directed by your doctor as part of your individual plan to manage EPI.

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Other important tips for maintaining your health
with EPI

  • Avoid smoking, which can exacerbate damage to your pancreas  
  • Limit or avoid alcohol, as advised by your doctor, especially if you have EPI caused by chronic pancreatitis 
  • Keep track of your GI symptoms, to share and discuss with your doctor and nutritionist
  • Take medications as prescribed, including a PERT, which should be taken with every meal and snack 

Your doctor can provide specific recommendations for managing EPI symptoms, but only if you’re open and honest about your experience. Get appointment tips now to learn how to help ensure the conversation is as productive as possible.

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Looking for more information?

Reference sources:

1. Alkaade S, Vareedayah AA. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. Am J Manag Care. 2017;23(12)(suppl):S203-S209. 2. Durie P, Baillargeon J-D, Bouchard S, Donnellan F, Zepeda-Gomez S, Teshima C. Diagnosis and management of pancreatic exocrine insufficiency (PEI) in primary care: consensus guidance of a Canadian expert panel. Curr Med Res Opin. 2018;34(1):25-33. 3. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 4. Nieto JM, Bastidas A. Exocrine pancreatic insufficiency: a literature review. Gastroenterol Hepatol Open Access. 2016;4(2):00092. doi:10.15406/ghoa.2016.04.00092. 5. Pezzilli R, Andriulli A, Bassi C, et al; Exocrine Pancreatic Insufficiency collaborative Group. Exocrine pancreatic insufficiency in adults: a shared position statement of the Italian Association for the Study of the Pancreas. World J Gastroenterol. 2013;19(44):7930-7946. 6. Ferrone M, Raimondo M, Scolapio JS. Pancreatic enzyme pharmacotherapy. Pharmacotherapy. 2007;27(6):910-920. 7. Liu AG, Ford NA, Hu FB, Zelman KM, Mozaffarian D, Kris-Etherton PM. A healthy approach to dietary fats: understanding the science and taking action to reduce consumer confusion. Nutr J. 2017;16(7):1-15. doi:10.1186/s12937-017-0271-4 8. Poti JM, Mendez MA, Ng SW, Popkin BM. Is the degree of food processing and convenience linked with the nutritional quality of foods purchased by US households? Am J Clin Nutr. 2015;101(6):1251-1262. doi:10.3945/ajcn.114.100925 9. Lindkvist B. Diagnosis and treatment of pancreatic exocrine insufficiency. World J Gastroenterol. 2013;19(42):7258-7266. 10. Health risks of smoking tobacco. American Cancer Society website. Published October 28, 2020. Accessed January 15, 2020.