Exocrine pancreatic insufficiency and pancreatitis have similar symptoms but different causes. Both of these conditions — and other pancreas disorders — are serious and require medical attention.
Exocrine pancreatic insufficiency (EPI) and pancreatitis are serious conditions that can affect your pancreas.
Chronic pancreatitis is one of the most common causes of EPI.
Chronic alcohol use and genetic mutations (changes) are among the most common causes of chronic pancreatitis.
Continue reading to learn more about the differences between EPI and pancreatitis, as well as other conditions that can affect your pancreas.
Your pancreas plays more than one role. It makes the insulin your body needs to regulate glucose. It also produces a large share of the enzymes you need to digest food and absorb nutrients.
If your pancreas is not working well, you’re likely to have at least some of the following signs and symptoms:
- abdominal tenderness, swelling, or pain
- nausea or vomiting
- excessive gas
- diarrhea
- foul-smelling stool
- light-colored stool
- fever
- weight loss
- malnutrition
These symptoms could be due to EPI, pancreatitis, or any of several other pancreas disorders.
Pancreatitis is inflammation of your pancreas. There are several types of pancreatitis with a variety of causes. The three main types are acute, chronic, and hereditary.
Acute pancreatitis
Acute pancreatitis comes on suddenly. Inflammation of your pancreas causes severe pain in your upper abdomen, which can last a few days. Other symptoms include:
- bloating
- nausea or vomiting
- diarrhea
- fever
Causes of acute pancreatitis include:
- gallstones
- chronic alcohol use
- trauma
- infection
- use of certain medications
- abnormalities in electrolytes, lipids, or hormones
- hereditary conditions
Treatment depends on the cause.
Chronic pancreatitis
Chronic pancreatitis is a progressive disease. In addition to upper abdominal pain, symptoms may include diarrhea and weight loss. As the disease progresses, it causes irreversible damage to your pancreas. This can lead to diabetes and malnutrition as a result of EPI.
Causes include:
- chronic alcohol use
- cystic fibrosis
- hereditary pancreas disorders
An estimated
Treatment depends on the cause and may include pancreatic enzyme replacement therapy (PERT), insulin, and pain management.
Hereditary pancreatitis
In many cases, chronic pancreatitis is caused by genetic mutations, including mutations of the genes PRSS1, SPINK1, and CFTR. Pancreatitis can also be hereditary or result from intestinal abnormalities.
Hereditary pancreatitis is a progressive disease. Treatment may include PERT and pain management.
EPI is a condition in which your levels of pancreatic enzymes are low enough to cause malnutrition. One symptom of EPI is steatorrhea, which is excess fat in stools. Signs of this are stools that are:
- pale
- foul-smelling
- difficult to flush
You may also experience oily leakage from your anus. Other possible symptoms include:
- abdominal bloating or cramping
- gas
- diarrhea or fecal incontinence
- weight loss
Causes of EPI include:
- pancreatitis
- cysts or benign tumors of your pancreas
- blockage or narrowing of your pancreatic or biliary duct
- pancreatic cancer
- side effects of pancreatic surgery
- cystic fibrosis
- diabetes
Treatment may include:
- PERT
- a low fat diet (unless you have cystic fibrosis)
- nutritional supplements, especially the fat-soluble vitamins A, D, E, and K
- avoidance of alcohol and smoking
Cystic fibrosis is a genetic condition that affects your lungs and digestive tract, including your pancreas. It’s usually diagnosed within the first few years of life. Signs and symptoms include:
- frequent respiratory infections
- coughing
- abdominal distension
- gas
- foul stools
- salty-tasting skin
- inability to gain weight
- developmental delays
- malnutrition due to EPI
Treatment may include:
- PERT
- a variety of medications to address respiratory issues
- breathing exercises and chest physiotherapy
- dietary management and nutritional supplementation
- lung transplant
Pancreatic cancer does not always cause symptoms early on. As it progresses, you may develop jaundice (yellowing of your skin and the whites of your eyes) and EPI. Treatment may include:
- surgery
- chemotherapy
- radiation
- pain management
- PERT
Diabetes is a condition in which your pancreas does not produce enough insulin or, if your pancreas does produce insulin, your body cannot use it effectively. Insulin is needed to distribute glucose to cells throughout your body.
Symptoms of unmanaged diabetes include:
- excessive hunger and thirst
- fatigue
- frequent urination
The connection between diabetes and EPI isn’t entirely understood. But diabetes can
Treatment for diabetes depends on the type, the symptoms, and any complications that have developed. Treatment may include dietary management, insulin, and blood sugar monitoring. If you have diabetes and develop EPI, your doctor may prescribe PERT.
Sometimes, EPI occurs after pancreas surgery for pancreatic cancer, cysts, or benign tumors.
It’s not necessary to consult a doctor if you have minor gas and bloating on occasion. But if you have frequent trouble with digestion, there are several conditions that could be causing your symptoms. It’s important to find the cause so you can get the right treatment.
If you have symptoms of EPI, such as abdominal pain, foul-smelling stools, and weight loss, contact your doctor right away. You may be malnourished and in need of treatment.
Pay particular attention to these symptoms if you’ve recently had pancreatic surgery or if you have any of the following conditions:
- acute or chronic pancreatitis
- pancreatic cancer
- cystic fibrosis
- diabetes
It’s also a good idea to talk with your doctor or pharmacist before adding over-the-counter digestive enzymes to your diet.
EPI and pancreatitis have some similar symptoms, such as abdominal discomfort, bloating, and gas. However, EPI tends to be a complication of pancreatitis. The characteristic symptom of EPI is pale, foul-smelling stools that can be difficult to flush.
EPI and pancreatitis are both serious conditions that require medical attention. If you have frequent or persistent digestive problems, treatments are available to help you manage your symptoms. Consult a doctor to get a diagnosis and find out whether you would benefit from treatment.