Fast Five Quiz: Exocrine Pancreatic Insufficiency Signs and Symptoms

Romesh Khardori, MD, PhD


March 08, 2021

The symptoms of EPI generally appear late in the disease course. Because the exocrine pancreas has a large reserve capacity for enzyme secretion, fat digestion is not clearly impaired until approximately 90% of the exocrine function of the pancreas is lost, or when lipase output decreases to below 10% of the normal level. Although this measurement is the current standard for determining fat malabsorption, it is important to consider that EPI can represent a graded response rather than a precise cut-off in pancreatic function. Particularly in view of the condition's indistinct presentation, patients may benefit from early testing.

EPI can often occur following acute pancreatitis (AP). Interestingly, however, development of significant pancreatic necrosis is not required for EPI to develop after AP.

Learn more about the workup of EPI.


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