Fast Five Quiz: Exocrine Pancreatic Insufficiency Signs and Symptoms

Romesh Khardori, MD, PhD


March 08, 2021

Figure 1. The pancreas, which acts as both an endocrine gland and a digestive organ.

The most common complaint of patients presenting with EPI is diarrhea, which is often watery due to the osmotic load from the intestine. Fat malabsorption causes steatorrhea characterized by pale, bulky, and malodorous stools that may float in toilet water with oily droplets and are difficult to flush.

The other major symptom of EPI is weight loss, often accompanied by fatigue. Weight loss may be worsened by an underlying disease involving the intestine. However, weight loss from malnutrition is not always apparent in patients who compensate by increasing their caloric consumption.

Other symptoms of EPI include flatulence and abdominal distention caused by bacterial fermentation of unabsorbed food substances, which releases gaseous products such as hydrogen and methane. Flatulence can produce uncomfortable abdominal distention and cramping.

Learn more about patient history in EPI.


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