Frequent gas, stomach pain, or diarrhea?It could be EPI.

Learn More


EPI happens when the pancreas doesn’t make enough of the enzymes necessary to digest the food you eat. As a result, your body cannot properly absorb the nutrients it needs. Sometimes EPI can go undetected and undiagnosed because many of the symptoms are similar to other gastrointestinal (GI) diseases.

Learn more about managing this condition.

What are the symptoms of EPI?

  • Stomach pain/cramps
  • Loose, oily, foul-smelling stools that are difficult to flush
  • Bloating
  • Gas
  • Diarrhea
  • Weight loss

Learn more about managing this condition.

Who can get epi?

EPI can be caused by diseases and conditions that affect the way the pancreas works. Cystic fibrosis (CF) is one of these diseases that begins at birth. Chronic pancreatitis (CP) is another condition linked to EPI that may happen later in life. If you have either CF or CP, you should talk to your doctor about EPI.

Cystic fibrosis (CF)
Chronic pancreatitis (CP)
Celiac disease
Gastric bypass surgery

What can you do
about it?

Sharing your symptoms, such as bloating, gas, diarrhea, and stomach pain and/or cramps, with your healthcare provider is a good place to start. And sooner may be better. Because there is no exact way to know when your pancreas will be most affected by EPI, it may help to get tested early, so your healthcare provider can develop an appropriate treatment plan for you.

Some tests used to diagnose EPI are:

Fecal elastase test

Elastase is a digestive enzyme made by the pancreas. It can be measured in stool samples to see how well the pancreas is working. Low levels of elastase can be an indicator of EPI. Some advantages of this test are that it doesn’t involve a special diet or having to collect stool samples over time.

Fecal fat test

This test measures how well your body absorbs fat. It involves eating a high-fat diet and collecting stool samples over 3 days. High amounts of fat in your stool could indicate EPI. This test is also helpful in evaluating the effectiveness of EPI treatment. However, some challenges include worsening symptoms and collecting samples for 3 days.

Direct pancreatic function test

This test offers a highly sensitive way to measure pancreatic function. That’s because it involves placing a tube in your small intestine to collect and measure pancreatic enzymes. Because the procedure is more involved than the other testing methods, some patients can find it difficult to tolerate.

Your own treatment will be based on the nature and severity of your specific symptoms. That’s why it’s important to give your healthcare provider a complete picture of how your symptoms are affecting your life.

To begin, list your symptoms with details to prepare for your appointment.

  • How many times per week do you experience the symptoms?
  • How long have you experienced the symptoms?
  • How severe are the symptoms? Do they disrupt your day?
  • Does anything seem to trigger the symptoms, for example, a type of food or stress?
  • If you notice changes in the consistency or form of your stool, write down the details.

Also, include any information that may help your healthcare provider learn more about your body and your health, such as:

  • A list of all the prescription medications you take, including prescription and non-prescription medicines.
  • Any big changes that have happened since your last visit: new health conditions, changes to your diet or exercise routine, or causes of stress.
  • And discuss whether you felt they were effective and any remedies or medications that you’ve tried in the past. Examples: prescription or non-prescription medications, adding more fiber to your diet, drinking more water, exercising, etc.

List any questions for your healthcare provider to make sure you cover your most pressing concerns.

Learn as much as you can about your condition so that you can take control of the conversations with your healthcare provider.

Check Your Symptoms

Download this PDF and note what you’ve
experienced for easy reference when talking to
your healthcare provider.


EPI Treatment Options

Diet and lifestyle changes: Your doctor may recommend making changes to your diet and lifestyle to help manage your symptoms. Depending on your diagnosis, these changes may include:

  • For patients with CP, eating a low-fat diet
  • For patients with CF, eating a high-fat diet (along with prescription medicine to replace the enzymes your pancreas no longer makes)
  • Adding fat-soluble vitamin supplements to your diet, such as vitamins A, D, E, and K
  • Talking to a dietitian about getting the right nutrition
  • Quitting smoking and/or not drinking alcohol

Medication: Your doctor may also recommend trying over-the-counter and/or prescription medications to help manage EPI symptoms. Talk to your doctor to find the right treatment for you.

Find out about a prescription treatment for EPI.