What are the symptoms of EPI?

Exocrine pancreatic insufficiency (EPI), sometimes called pancreatic insufficiency for short, is the inability to break down and digest food properly.

Symptoms of EPI can vary, but if you have one or more of these symptoms, you should talk to your doctor. Talking to your doctor is important since only your doctor can tell if your symptoms are due to EPI or another gastrointestinal condition.


EPI can cause problems with undigested food moving too quickly through the digestive tract.

Gas and bloating

People with EPI cannot properly digest the food they eat, which can result in uncomfortable symptoms like gas and bloating.

Stomach pain

Fat maldigestion due to EPI can lead to gas, bloating, and stomach pain.

Foul-smelling, greasy stools (steatorrhea)

Steatorrhea is a type of bowel movement that is oily, floats, smells really bad, and is difficult to flush. People with EPI are not able to absorb all of the fat that they eat, so undigested fat is excreted, resulting in stools that look oily or greasy. Not all people experience this symptom.

Talk to your doctor if you notice oil droplets floating in the toilet bowl or stools that float or stick to the sides of the bowl and are hard to flush; it may be a sign of EPI.

Weight loss

EPI affects protein and carbohydrate digestion, but the greatest impact comes from fat maldigestion, which is the primary cause of weight loss in people with EPI.

Only your doctor can tell if your symptoms are due to EPI or another digestive condition. Use our EPI Symptom Checker to help you identify your symptoms, and share the results with your doctor at your next visit.

Sources: 1. Ferrone M, Raimondo M, Scolapio JS. Pancreatic enzyme pharmacotherapy. Pharmacotherapy. 2007;27(6):910-920. 2. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 3. Alkaade S, Vareedayah AA. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. Am J Manag Care. 2017;23(suppl 12):S203-S209.