What is Exocrine Pancreatic Insufficiency?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 23 April 2019
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Exocrine pancreatic insufficiency is a metabolic disorder where the pancreas doesn't produce the right enzymes and people have trouble digesting food. This condition can be seen in pet cats and dogs, as well as people, and it has a number of causes ranging from congenital conditions to acquired medical problems. Treatment involves supplementing the diet with pancreatic enzymes to aid digestion and monitoring levels of vitamins to determine if vitamin supplementation is needed as well.

In a person with exocrine pancreatic insufficiency, the pancreas is often shriveled in size, and testing will reveal imbalances of needed enzymes. The patient can also develop clear symptoms of malnutrition caused by the poor digestion, ranging from diarrhea to rapid weight loss. Common congenital causes include genetic conditions like Shwachman-Diamond syndrome and cystic fibrosis. People with diabetes also sometimes develop this condition, and chronic pancreatitis can lead to exocrine pancreatic insufficiency.

If a doctor suspects a patient has this condition on the basis of history and a patient interview, blood tests can be requested to collect information. The patient may also be sent for medical imaging studies to see if the pancreas have an abnormal size. Risk factors like having cystic fibrosis can speed diagnosis. After diagnostic testing, the doctor can review the results, determine the cause if it wasn't already evident, and develop a treatment plan.


Treatment for exocrine pancreatic insufficiency usually requires some dietary changes. The patient will be switched to a high-digestibility diet with the goal of making it easier to process foods. The balance of this diet can vary, depending on the patient's needs, and usually includes lots of fiber. Digestive enzymes can be sprinkled into the food and pets may be given raw pancreas to get digestive enzymes directly from the source. If vitamin supplementation is needed, these can be added to the diet as appropriate.

People with exocrine pancreatic insufficiency will need to be monitored for life for signs of changes in their condition and to check for malnutrition and other issues. Regular testing along with physical examinations is usually recommended, and patients will need to make lasting dietary changes. People who have trouble sticking with a diet can meet with a nutritionist or dietitian to discuss ways to meet their needs. Nutritionists and dietitians can offer tips and tricks on food preparation, including recipes, new ways of combining foods, and so forth. A doctor may have a referral for a nutrition professional who can help a patient establish and comply with a prescribed diet.



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