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If you’re experiencing severe abdominal pain, fever, or heavy bleeding, call 911.

Pancreatic Insufficiency

Pancreatic Insufficiency Explained

EPI often occurs as a result of chronic pancreatitis, cystic fibrosis, pancreatic surgery, or other pancreatic diseases. Because the pancreas cannot supply enough enzymes to the intestine, fats and other nutrients are not properly absorbed, causing weight loss, vitamin deficiencies, and characteristic changes in stool. Treatment with pancreatic enzyme replacement therapy (PERT) can significantly improve digestion and nutritional status.

Symptoms

Symptoms are mainly related to poor digestion—oily, difficult-to-flush stools, bloating, gas, and weight loss despite eating.

Symptoms include:
Frequent, bulky, pale, or oily stools that may float (steatorrhea)
Bloating, gas, and abdominal discomfort
Unintentional weight loss
Fatigue and signs of vitamin deficiency (hair/skin changes, bone issues)

When to call

Call the office if you suspect EPI due to chronic digestive symptoms and weight loss, or if you already have EPI and your symptoms are not improving with enzyme therapy.

Seek emergency care for severe abdominal pain, persistent vomiting, or signs of severe malnutrition (extreme weakness, fainting), especially if combined with other serious symptoms.

Evaluation & Tests
Management & Treatment

Evaluation combines a history of symptoms and risk factors, stool tests for fat or enzyme markers, blood tests for nutritional deficiencies, and imaging to look at the pancreas.

History of pancreatitis, pancreatic surgery, or cystic fibrosis
Stool tests (such as fecal elastase) to assess pancreatic enzyme output
Assessment of dietary intake and weight change
Blood tests for fat-soluble vitamin levels and other nutritional indicators
Imaging to evaluate pancreatic structure when needed

The main treatment is pancreatic enzyme replacement therapy (PERT) taken with meals and snacks, combined with nutrition guidance and management of the underlying pancreatic condition.

Pancreatic enzyme capsules with meals and snacks, adjusted to dose and body weight
Diet tailored to individual tolerance; sometimes moderated fat, but not fat-free
Vitamin supplementation, especially fat-soluble vitamins (A, D, E, K) where needed
Avoiding alcohol and smoking if relevant to underlying disease
Regular follow-up to fine-tune enzyme dosing and monitor nutrition
This information is for general educational purposes only and is not a diagnosis or personalized medical advice. It does not replace a visit with your own healthcare provider. Always follow the specific recommendations given by your medical team. If you have urgent or worsening symptoms, contact your provider or seek emergency care right away.

At-a-glance

Abdominal painBloating / gasDiarrheaWeight loss / anemia

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Information on this website is for education only and not a substitute for medical advice.

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