Diagnosis and Management of Exocrine Pancreatic Insufficiency

Abstract

Exocrine pancreatic insufficiency (EPI) may occur due to a variety of causes depending on the age of the patient, and making the diagnosis can be challenging due to a lack of reliable diagnostic testing approaches. This review summarizes the approach to diagnosis and treatment of patients with EPI. In patients at risk of EPI, timely diagnosis and treatment are important to optimize nutritional status, quality of life, and survival. EPI without overt steatorrhea may be subclinical with nutritional impacts such as weight loss or growth failure and nutrient malabsorption. Providers should be familiar with available indirect and direct tests and know when such tests will facilitate accurate diagnosis and appropriate, prompt treatment. Identification of at-risk patients, appropriate diagnostic testing, and appropriate PERT dosing are necessary to provide quality care for patients with EPI.