Consider EPI in your differential diagnosis1

Patients with EPI may present with signs and symptoms similar to other GI conditions or diseases.

Signs and symptoms of EPI may include2-5:

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Diarrhea

(frequent, soft bowel
movements)

Hands clutching a stomach

Abdominal pain

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Bloating

A gas cloud

Flatulence

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Unexplained
weight loss

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Steatorrhea*

*Steatorrhea: >7 g of fecal fat per day while consuming 100 g of dietary fat per day.5

References: 1. Leeds JS, Oppong K, Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011;8(7):405-415. 2. Ferrone M, Raimondo M, Scolapio JS. Pancreatic enzyme pharmacotherapy. Pharmacotherapy. 2007;27(6):910-920. 3. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 4. Alkaade S, Vareedayah AA. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. Am J Manag Care. 2017;23(suppl 12):203S-209S. 5. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. 6. Longo DL, Fauci AS, Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 18th ed. New York, NY: McGraw-Hill; 2012. 7. Celiac disease symptoms. Celiac Disease Foundation website. https://celiac.org/celiac-disease/understanding-celiac-disease-2/celiacdiseasesymptoms. Accessed August 16, 2018. 8. Ruiz AR Jr. Bacterial overgrowth syndrome. Merck Manual Professional Version website. https://www.merckmanuals.com/professional/gastrointestinal-disorders/malabsorption-syndromes/bacterial-overgrowth-syndrome. Updated February 2018. Accessed August 16, 2018. 9. Lichtenstein G. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2012:913-921. 10. Sands BE, Siegel CA. Crohn’s disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. Vol 2. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:1941-1973. 11. Dumasy V, Delhaye M, Cotton F, Deviere J. Fat malabsorption screening in chronic pancreatitis. Am J Gastroenterol. 2004;99(7):1350-1354. 12. Hart PA, Conwell DL. Diagnosis of exocrine pancreatic insufficiency. Curr Treat Options Gastroenterol. 2015;13(3):347-353. 13. Smith RC, Smith SF, Wilson J, et al; Working Party of the Australasian Pancreatic Club. Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency. Pancreatology. 2016;16(2):164-180.