Question: What is EPI?
Answer: Exocrine pancreatic insufficiency (EPI) is a condition in which your small intestine can’t digest food completely because of problems with digestive enzymes from your pancreas. EPI often develops slowly, over many years.

The pancreas is a large gland behind your stomach. The pancreas is both

anendocrine glandthat makeshormones
anexocrine glandthat makes digestive juice containing enzymes

The pancreas delivers the digestive juice to the small intestine through a single duct. In the small intestine, the enzymes from the pancreas help digest food, breaking down carbohydrates, fats, and proteins.

You may develop EPI if

the amount of enzymes your pancreas makes is severely reduced
not enough enzymes reach your small intestine
other problems prevent the enzymes from mixing with food or otherwise working well

The pancreas is a large gland that makes digestive juice containing enzymes.
Question: How common is EPI?
Answer: EPI is rare. However, problems with enzymes from the pancreas occur more often in people with certain health conditions.

Although study results vary, experts think problems with enzymes from the pancreas may occur in1

30% to 90% of people withchronicpancreatitis
80% to 90% of people withcystic fibrosis

Less commonly, problems with enzymes in the pancreas may occur in people who have

pancreatic cancerthat has not been removed by surgery
type 1 diabetesortype 2 diabetes
inflammatory bowel disease
untreatedceliac disease
surgery of the pancreas orupper gastrointestinal tract
Sjogren’s syndrome
a history of smoking or drinking alcohol
Question: Who is more likely to have EPI?
Answer: People who have advanced pancreatic diseases are more likely to develop EPI. For example, EPI is more common in people who have

chronic andacutepancreatitis
cystic fibrosis
pancreatic cancer
surgery of the pancreas or upper gastrointestinal tract
Question: What are the complications of EPI?
Answer: In EPI, the small intestine doesn’t digest food as it should and may not absorb enough nutrients—a condition called malabsorption. EPI and malabsorption can lead to complications such as

malnutrition
low levels of fat-solublevitaminsA, D, E, and K in the body
lowbone mass, called osteopenia, andosteoporosis
problems with growth in children
weakness of theimmune system
increased risk of cardiovascular events, such asheart attackandstroke