How is EPI diagnosed?

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 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 you’ve been diagnosed with
  • Your eating habits
  • Any and all symptoms you’ve been experiencing and the 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 herbals you may be taking

Your primary care physician may be able to provide an accurate 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.

Tests used to diagnose EPI

The 3 main tests used to diagnose EPI 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. Your doctor may not use this test if you have diabetes.

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, greasy 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.

Direct 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.

Sources: 1. Gardner TB, Warner AS, eds. Questions & Answers About Diseases of the Pancreas. Burlington, MA: Jones & Barlett Learning; 2012. 2. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011:4:55-73. 3. Domínguez-Muñoz JE. Pancreatic insufficiency: diagnosis and treatment. J Gastroenterol Hepatol. 2011;26(suppl 2);12-16.