Question

An Overview About Exocrine Pancreatic Insufficiency!

Dr.Lovkesh Anand · Accepted Answer

Exocrine Pancreatic Insufficiency (EPI), also called pancreatic deficiency, is a disorder where the pancreas is unable to produce a sufficient amount of enzymes that are required to digest food. The pancreatic enzymes help to break down and absorb nutrients from the food in the small intestine. So, this disease causes nutritional deficiencies.

Causes of Exocrine Pancreatic Insufficiency-
This condition is generally caused as a complication of other diseases because EPI develops only as a result of severe damage to the pancreas. The following reasons can cause EPI:

1. Inflammation of the pancreas-
After surgery in the pancreas, stomach or the intestines, there may be inflammation in the pancreas as a post-surgical complication. The high content of triglyceride fat in the blood can also cause pancreatic inflammation and hinder the secretion of the enzymes.
2. Chronic Pancreatitis-
In this disease, the pancreatic ducts are swollen and blocked and so the digestive enzymes cannot be passed into the small intestine. This condition is often caused by heavy consumption of alcohol.
3. Cystic Fibrosis-
The digestive fluids and enzymes become thick and sticky and block the passageways of the pancreas and other organs like the lungs and the kidneys. This can obstruct secretion and passage of enzymes afterward.
4. Shwachman-Bodian-Diamond syndrome-
This is an autosomal recessive genetic condition where enzyme-producing pancreatic cells are not formed properly. This rare disorder causes a number of associated disorders like bone marrow diseases, skeletal defects and exocrine pancreatic insufficiency.

Symptoms of Exocrine Pancreatic Insufficiency-
The symptoms appear in the middle stages of the disease when the process of absorption of nutrients has already been affected. The common warning signs are:
1. Digestive problems like gas, diarrhea and indigestion because the food remains mostly undigested.
2. Severe and frequent stomach pain in the lower abdominal region
3. Greasy stools due to the excretion of undigested fat
4. Rapid loss of weight and body mass due to mal-absorption of nutrients
5. Constantly feeling bloated and full even if you have not eaten anything
6. A general sense of fatigue and exhaustion
7. Excessive bleeding from small wounds because protein deficiencies hamper blood clotting
8. Pain in the muscles and bones
9. Increased susceptibility to infections of the body systems
10. Anemia
11. Joint pains
12. Abnormal swelling of the limbs or edema

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