Exocrine Pancreatic Insufficiency Questions & Answers

Updated: Feb 03, 2020
  • Author: Samer Al-Kaade, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Questions & Answers

Overview

What is exocrine pancreatic insufficiency (EPI)?

What is the anatomy of the pancreas in exocrine pancreatic insufficiency (EPI)?

What is the pathophysiology of exocrine pancreatic insufficiency (EPI)?

How is exocrine pancreatic insufficiency (EPI) characterized?

What are pancreatic causes of exocrine pancreatic insufficiency (EPI)?

What are nonpancreatic causes of exocrine pancreatic insufficiency (EPI)?

What is the prevalence of exocrine pancreatic insufficiency (EPI)?

What is the natural history and progression of exocrine pancreatic insufficiency (EPI), and what is its association with cardiovascular events?

Presentation

What are the symptoms of exocrine pancreatic insufficiency (EPI)?

How is steatorrhea characterized in exocrine pancreatic insufficiency (EPI)?

How is weight loss and fatigue characterized in exocrine pancreatic insufficiency (EPI)?

What causes flatulence and abdominal distention in exocrine pancreatic insufficiency (EPI)?

What causes edema in exocrine pancreatic insufficiency (EPI)?

What causes anemia in exocrine pancreatic insufficiency (EPI)?

What causes bleeding disorders in exocrine pancreatic insufficiency (EPI)?

How is metabolic bone disease characterized in exocrine pancreatic insufficiency (EPI)?

How are neurologic symptoms characterized in exocrine pancreatic insufficiency (EPI)?

What are the physical findings in exocrine pancreatic insufficiency (EPI)?

DDX

What are diagnostic considerations in exocrine pancreatic insufficiency (EPI)?

What are the differential diagnoses for Exocrine Pancreatic Insufficiency?

Workup

Which lab studies are indicated in the workup of exocrine pancreatic insufficiency (EPI)?

Which blood tests are indicated in the workup of exocrine pancreatic insufficiency (EPI)?

Why is a full malabsorption workup indicated in suspected exocrine pancreatic insufficiency (EPI)?

What is involved in a fat absorption test in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in D-xylose test in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in carbohydrate absorption test in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in bile salt absorption test in the workup of exocrine pancreatic insufficiency (EPI)?

How is the Schilling test used in the workup of exocrine pancreatic insufficiency (EPI)?

How is the C-D-xylose breath test used in the workup of exocrine pancreatic insufficiency (EPI)?

How is pancreatic function measured in the workup of exocrine pancreatic insufficiency (EPI)?

What are the benefits of direct pancreatic function testing in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in secretin test in in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in cholecystokinin (CCK) test in the workup of exocrine pancreatic insufficiency (EPI)?

What is involved in secretin- CCK test in the workup of exocrine pancreatic insufficiency (EPI)?

What are the benefits of indirect pancreatic function testing in the workup of exocrine pancreatic insufficiency (EPI)?

What is the purpose of abdominal imaging in the workup of exocrine pancreatic insufficiency (EPI)?

Treatment

What are the management approaches to exocrine pancreatic insufficiency (EPI)?

What is the focus of long-term monitoring in patients with exocrine pancreatic insufficiency (EPI)?

What are the benefits of pancreatic enzyme replacement therapy (PERT) in the treatment of exocrine pancreatic insufficiency (EPI)?

What pancreatic enzyme products (PEPs) are used for PERT in exocrine pancreatic insufficiency (EPI)?

How are pancreatic enzyme products (PEPs) administered in PERT in the treatment of exocrine pancreatic insufficiency (EPI)?

What is the pancreatic enzyme products (PEPs) dosing in PERT for the treatment of exocrine pancreatic insufficiency (EPI)?

What is the pancreatic enzyme products (PEPs) dosing for exocrine pancreatic insufficiency (EPI) due to pancreatitis or pancreatectomy?

What is the efficacy of pancreatic enzyme products (PEPs) in PERT for the treatment of exocrine pancreatic insufficiency (EPI)?

What is the role of liprotamase in pancreatic enzyme replacement therapy (PERT) for exocrine pancreatic insufficiency (EPI)?

Medications

What are the goals of drug treatment for exocrine pancreatic insufficiency (EPI)?

Which medications in the drug class Pancreatic Enzyme Products are used in the treatment of Exocrine Pancreatic Insufficiency?