Challenges
to Diagnosis
Diagnosing EPI can be difficult because of multiple factors
EPI may be overlooked as a diagnosis
- Patients with Exocrine Pancreatic Insufficiency (EPI) may present with signs and symptoms similar to those of other GI conditions1
- A study conducted by the American Gastroenterological Association showed that 1 in 4 patients had their diagnosis changed to EPI after initially being diagnosed with another GI condition2*
Patients may not be comfortable talking about symptoms
- Patients may find it difficult to discuss GI issues with their doctor and may be embarrassed to disclose their symptoms2
- A study conducted by the American Gastroenterological Association showed that patients waited an average of 4 years to see a doctor about their GI symptoms—and 60% of them held off due to embarrassment of discussing symptoms2
Looking for EPI diagnostic tips? Hear from Rogelio Silva, MD, as he shares some advice for physicians who are clinically diagnosing EPI.
Some symptoms suggestive of EPI may be present up to 3 years before pancreatic enzyme replacement therapy (PERT) initiation3†
Average time from symptoms suggestive of EPI onset to the initiation of PERT Rx claim
Average time from symptoms suggestive of EPI onset to the initiation of PERT Rx claim
Average time from symptoms suggestive of EPI onset to the initiation of PERT Rx claim
Watch a short video featuring physicians who offer insights into diagnosing EPI via telemedicine.
UC=ulcerative colitis.
*EPI Uncovered is based on an online survey conducted by Harris Poll from May 17 through June 20, 2016. It included 1,001 U.S. adults ages 18 and older who experienced at least two gastrointestinal issues, three or more times in the past three months (“patients”), as well as 250 primary care physicians (“PCPs”) and 250 gastroenterologists (“GIs”) in the U.S. who are ages 18 years or older and licensed. Figures for patients were weighted where necessary based on age, education, gender, race/ethnicity, region, income, size of household, marital status, and likelihood to be online to bring them into line with their actual proportions in the population. Figures for PCPs and GIs were weighted on years in practice, gender and region, where necessary, to bring them into line with their actual proportions in the population.
†Retrospective study to quantify the time between the presence of symptoms suggestive of EPI prior to initiating a PERT. To be eligible for the study, a patient must have a history of at least 1 medical claim during the 5-year study period of 2011-H2 to 2017-H2 AND at least one of the following criteria within study period: 1) 2 additional PERT claims after PERT initiation (3 total PERT claims) 2) a diagnosis of EPI, 3) the occurrence of a pancreatectomy procedure or 4) a diagnosis of either pancreatic cancer, cystic fibrosis or chronic pancreatitis. Time to PERT is based on the first occurrence of the symptom code to PERT Rx claim.
References: 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. EPI Uncovered. American Gastroenterological Association website. https://s3.amazonaws.com/agaemailassets/images/EPI_Uncovered_AGA_Survey_Infographic.pdf. Published October 24, 2016. Accessed November 13, 2020. 3. Data on file. AbbVie Inc. Source: SHS data (2015-2017), 2017.