Exocrine Pancreatic Insufficiency, or EPI, can cause a variety of digestive problems and fortunately can be easily treated. However, it’s usually a symptom rather than a cause, and if you treat the symptom and neglect the cause, then the treatment probably won’t work very well or for very long.

I’ll explain exactly what exocrine pancreatic insufficiency is, how it’s treated and even how you can treat it without a prescription, and what you should know about it that your doctor probably didn’t tell you.

We routinely work with patients with enzyme problems, and we are experts in the use of enzymes.

What is EPI?

Enzymes are chemicals that your body produces that help you to break down foods so that you can digest and absorb the nutrients within those foods.

Many enzymes are produced by your pancreas, although I like to emphasize that enzymes also come from other places, such as your food, the cells that line your intestinal tract, and even the bacteria contained in your microbiome.

EPI, or Exocrine Pancreatic insufficiency, means that your pancreas is not producing enough enzymes.

What Causes EPI?

True pancreatic insufficiency is quite rare, and is primarily found in people with cystic fibrosis, pancreatitis or pancreatic cancer. In each of these conditions there is a much higher likelihood that your pancreas is not providing you with enough enzymes to properly break down your food.

However, diabetes, inflammatory bowel disease, and other digestive disorders such as IBS can also contribute to poor enzyme production.  

What Are They Symptoms of EPI?

Enzymes have a variety of uses and benefits and can help with many different types of digestive issues. People with EPI often experience abdominal pain, gas, bloating, diarrhea or constipation, and often have trouble digesting fats.

Of course, LOTS of other things can also cause these symptoms. However, even when something other than EPI is causing your symptoms, taking enzymes may help you feel better because it will help you to break your foods down better, which may relieve some of the stress on an already inflamed or irritated digestive tract.  

How Do You Treat EPI?

EPI is relatively easy to treat. You merely need to take enzyme capsules with your meals. There is a prescription enzyme product called Creon, but anyone can access the same enzymes on their own, even ones that are just as strong or stronger than Creon, over the counter without a prescription. There is nothing special about Creon.

However, there are many, many different kinds of enzyme products on the market, and they are not all the same. Some may be much more effective for you than others, and their effectiveness may differ from person to person. So you may have to experiment with them in order to figure which, if any, are helpful.

But Beware:

Of the well over 10,000 patients that we’ve treated, very, very few have had true EPI.  But many people have found enzymes to be helpful. What I’ve seen happen with most of these patients is that the enzymes have been treating the symptom, and not the cause. It wasn’t that they were deficient in enzymes, but they were having trouble breaking their food down for another reason and the extra enzymes were masking the other problem.

Therefore, they only got a little bit better, and the true cause of their symptoms never went away. So, the enzymes often only worked temporarily or irregularly.

Or they had low enzyme production from conditions like IBS, but once the cause of it was addressed and treated, they were able to recover their enzyme production.

If you need assistance sorting out any of these issues, we can help.  At the IBS Treatment Center we test people for pancreatic insufficiency, and more importantly, we also look for and address ALL of the causes of the symptoms of abdominal pain, diarrhea, gas, and bloating that aren’t being evaluated by the gastroenterologist. There is ALWAYS  a reason for those symptoms.  They don’t just happen accidentally, and our job is to help you find out why they are happening.

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