HOW IS EPI
If you think you could have EPI, the first step you should take is to talk to your doctor. It’s important that you open up and be specific. Tell your doctor about any and all symptoms you may be experiencing. You should remember to share the following information with your doctor:
- Any conditions or procedures in your medical history (not just a pancreatic insufficiency diagnosis)
- Your eating habits and diet
- Any and all symptoms you’ve been experiencing and the frequency and severity of your symptoms
- When your symptoms started
- If you've had unexplained weight loss
- Any differences in your stools and bowel movements
- Any medications or herbal supplements you may be taking
Your primary care physician may be able to provide an accurate EPI diagnosis and discuss treatment options. Or, your doctor may refer you to a specialist. If your doctor refers you to a specialist, it will likely be a gastroenterologist. Gastroenterologists specialize in disorders of the gastrointestinal tract—this includes the stomach, intestines, pancreas, liver, and gallbladder—and do many of the tests used to diagnose pancreatic conditions, including EPI.
The 3 main EPI tests used to aid in diagnosis are:
Fecal elastase test
This test measures the amount of elastase, an enzyme produced by the pancreas, in your stool. A deficiency of elastase could be an indicator of EPI. It may be harder to diagnose milder EPI using this test.
Fecal fat test
This test checks the amount of fat in your stool. This test can help determine how much fat your body is not absorbing. It can also reveal evidence of steatorrhea (foul-smelling, oily stools). Some people find this test to be difficult because it requires eating a prescribed diet and collecting and handling stool samples over 3 days.
Pancreatic function test
This type of test is considered the most accurate way to assess the exocrine function of your pancreas. It involves inserting a tube into your small intestine to collect pancreatic secretions. This test is usually performed only at specialized centers and its use is limited.
If you are diagnosed with EPI, it’s important to remember that it’s a manageable condition when treated per your doctor or gastroenterologist’s recommendations. This may include pancreatic enzyme replacement therapy (PERT).
1. What is a gastroenterologist? American College of Gastroenterology website. https://gi.org/patients/gi-health-and-disease/what-is-a-gastroenterologist/. Accessed January 13, 2021. 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. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. 4. 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.