Exocrine pancreatic insufficiency (EPI) is a chronic disorder easily confused with other long-standing gastrointestinal diseases. Because of this, it can be difficult to reach a diagnosis quickly, and the whole story ends up becoming a long road to knowing the truth.
The two most common diseases it is associated with are celiac disease and Crohn’s disease, two chronic disorders that have an important relationship with the immunity of our body. Despite these similarities in symptoms, EPI can be diagnosed properly when placed in the hands of a specialist with experience in these types of disorders.
What Is Exocrine Pancreatic Insufficiency?
EPI is a disorder characterized by the inability of the pancreas to properly produce and secrete the enzymes that, under normal conditions, maintain digestion.
While there are many causes of this condition, it is most often caused by untreated chronic pancreatitis. Even celiac disease itself or Crohn’s disease could be the reason EPI develops. It is important to keep in mind that the origin of the disease should always be sought, not just its diagnosis.
What Are the Symptoms of Exocrine Pancreatic Insufficiency?
The list of symptoms focuses on, but is not limited to, the gastrointestinal tract. The most important, and most frequent symptom is chronic diarrhea accompanied by large amounts of fat in the stool, which is known as steatorrhea.
Patients often pass yellowish, liquid stools several times a day.
Furthermore, it is also frequent to observe patients with abdominal distension and a lot of flatulence, due to the accumulation of large amounts of bacteria by food that was not absorbed (due to enzyme deficiency). Epigastric pain is common, as is unintentional weight loss, which is why EPI can be confused with celiac disease and Crohn’s disease.
However, the symptoms are not limited to the digestive system alone. There can also be edema, anemia, hemorrhagic disorders, bone, and even neurological problems due to nutritional deficits.
The multitude of varying symptoms can contribute to making exocrine pancreatic insufficiency difficult to diagnose.
How Is Exocrine Pancreatic Insufficiency Diagnosed?
The ability to get a diagnosis is based very much on the clinic. Although it may go unnoticed for years, because of its similarity to other disorders, there are several tests that can guide medical professionals in its proper diagnosis. The most important ones are to rule out celiac disease and Crohn’s disease in the first place, due to the great frequency with which they are confused.
Once this is done, direct pancreatic tests can be done to help measure the functioning of the pancreas, such as the secretin-cholecystokinin test.
How Is Exocrine Pancreatic Insufficiency Treated?
The treatment of EPI is multidisciplinary and involves several different therapies. The first are non-pharmacological measures, among which diet stands out. It is necessary to clarify that all the absorption of nutrients changes when we do not have the necessary enzymes to break down our food, so it is necessary to supplement these losses with vitamins, minerals, and other compounds that are needed.
It is also likely that your doctor will prescribe pancreatic enzymes directly, but this depends on the amount of fat you excrete in your stools. If you need these enzymes, you should always take them before each meal (or as prescribed).
Treatments can and do vary based on disease, the professional treating the condition, and the patient.
EPI is a chronic gastrointestinal disease that can greatly affect your quality of life. Receiving a proper diagnosis can be a bit tricky, especially if your symptoms are confused with other diseases. Thankfully, there are definitive studies that can guide medical professionals to an accurate diagnosis.
Exocrine pancreatic insufficiency is a disease that can be controlled through multidisciplinary treatment, including dietary changes and supplements, so you can recover your quality of life.