If you’ve received an exocrine pancreatic insufficiency (EPI) diagnosis, you might come across some new medical terms when talking with your doctor. Here are the most common ones to familiarize yourself with.

Exocrine pancreatic insufficiency (EPI) is when the pancreas doesn’t produce enough digestive enzymes to break down foods and absorb nutrients.

EPI can occur with different types of disorders, such as:

  • pancreatitis
  • cystic fibrosis
  • surgery of the pancreas or upper gastrointestinal tract
  • celiac disease
  • inflammatory bowel diseases
  • pancreatic cancer

Symptoms can include:

  • abdominal pain
  • bloating
  • gas
  • fatty stools
  • constipation
  • diarrhea
  • unexplained weight loss

After your doctor makes a diagnosis, they can recommend treatment to help improve your symptoms. As you go through this process, you might hear some terms that you aren’t familiar with.

In no particular order, here are 11 words you need to know when living with EPI.

Your pancreas is a gland located behind your stomach. It is a vital organ that affects digestion and blood sugar.

The pancreas produces digestive juices (enzymes) that help your body break down food. It also produces insulin, a hormone that allows your body to use glucose for energy.

Digestive enzymes are proteins produced by your body. They help break down the foods you eat. This allows your body to receive nutrients from foods.

Digestive enzymes produced by the pancreas include:

  • amylase, which breaks down carbohydrates
  • lipase, which breaks down fats
  • protease and elastase, which break down proteins

This refers to an inability to absorb nutrients from the foods you eat. More specifically, your small intestine isn’t able to absorb nutrients.

These include macronutrients like proteins, carbohydrates, and fats, as well as micronutrients like vitamins and minerals.

Malabsorption occurs with EPI due to a lack of digestive enzymes. However, it can also occur with other conditions, such as celiac disease, pancreatitis, and cystic fibrosis.

Symptoms of malabsorption can vary depending on the nutrients your body has difficulty absorbing. These symptoms may include:

  • gas
  • abdominal discomfort
  • diarrhea
  • unexplained weight loss

This type of therapy uses oral medication to replace the digestive enzymes that your pancreas no longer makes. When taken before meals and snacks, PERT provides your body with the necessary enzymes to digest foods and break down carbohydrates, fats, and proteins.

PERT can relieve symptoms associated with EPI, such as diarrhea and abdominal pain. It can also help improve your quality of life and help maintain a moderate weight.

This is inflammation, or swelling, of the pancreas. Inflammation occurs when digestive enzymes damage tissue within the pancreas.

Pancreatitis can be acute or chronic. Acute symptoms are sudden and short term, whereas chronic pancreatitis is an ongoing condition. Symptoms include:

  • pain in the upper abdomen that spreads to the back
  • pain that worsens after eating
  • nausea
  • vomiting
  • fever
  • unexplained weight loss

Chronic pancreatitis is the leading cause of EPI in adults.

Steatorrhea occurs when there’s too much fat in your feces (stool). Signs of steatorrhea include bulky stools, as well as oily or greasy stools due to undigested fat.

An excess amount of fat can also cause foul-smelling stools. Stools may float in the toilet and be difficult to flush.

Other symptoms that can accompany steatorrhea include:

  • chronic diarrhea
  • abdominal pain
  • bloating
  • weight loss

Steatorrhea is the most common sign of EPI.

Cystic fibrosis is an inherited disease that causes breathing and digestion issues. The condition is due to a mutation in a gene called cystic fibrosis transmembrane conductance regulator (CFTR). This mutation causes thick, sticky mucus to clog the lungs, making it more difficult to breathe and allowing bacteria to grow more easily.

People with cystic fibrosis have repeated lung infections and lung damage. Symptoms include:

  • salty-tasting skin
  • a chronic cough that produces thick mucus or blood
  • recurring chest colds
  • wheezing or shortness of breath
  • frequent sinus or lung infection
  • nasal polyps

Cystic fibrosis is a common cause of EPI. A 2023 study found that 80% to 90% of people with cystic fibrosis have EPI.

Your doctor may use this test to help diagnose EPI. It measures the amount of elastase in your stool.

Elastase is a pancreatic enzyme that breaks down proteins in foods. If you have very little or no elastase in your stool, it is a sign that your pancreas isn’t working as expected.

Your doctor might schedule this test if you have abdominal pain, greasy stools, or unexplained weight loss. You’ll provide a stool sample for this test, which a laboratory tests for microscopic examination.

This test measures the amount of fat in your stool. Your doctor may use it to diagnose steatorrhea.

An increased amount of fat means that food passes through your digestive system without being completely broken down. This indicates that your pancreas is not producing digestive enzymes as expected and your small intestine is not absorbing food.

Your doctor may request a single stool sample or collect multiple samples over several days.

This hormone, which your intestines produce, plays a role in healthy digestion. Secretin helps regulate water and other fluids in the body.

It also stimulates the secretion (release) of pancreatic fluid, which contains the digestive enzymes necessary to break down carbohydrates, fats, and proteins.

This test measures how well your pancreas responds to the hormone secretin. During this test:

  1. A doctor will guide a tube down your throat into your stomach, then your small intestine.
  2. You’ll receive an intravenous dose of secretin.
  3. Your body releases pancreatic fluid, which is then collected and tested for digestive enzymes.

A test that shows little or no presence of digestive enzymes is a sign that your pancreas isn’t working correctly, which can help diagnose EPI.

If you’ve recently received a diagnosis of EPI, you’ll know it’s associated with conditions like pancreatitis, cystic fibrosis, and celiac disease.

As you learn more about your symptoms and treatment, you will likely find terms that you’re not familiar with. These include the pancreas, which produces the digestive juices (or enzymes) that help your body break down food, and pancreatic enzyme replacement therapy, a type of treatment for EPI.

Learning more about the terms related to EPI can help you manage the condition more easily.