Can't digest food? Stomach ache? This could be EPI (Exocrine Pancreatic Insufficiency)

Do you often feel full after meals, have stomach pain, and have foul-smelling, oily stools? You may also be losing weight for no reason. These are not symptoms to ignore. Today we are talking about a condition called Exocrine Pancreatic Insufficiency, or EPI for short, which can cause these symptoms.

Simply put, what is EPI?

Okay, let's put it this way. We have an organ called the pancreas in our stomach. Its main job is to produce enzymes , a special type of chemical that helps us digest the food we eat. These enzymes go into our small intestine and break down the food we eat, especially oils and fats, so that our body can absorb them.

Now, what happens to someone with EPI is that the pancreas doesn't produce enough enzymes. What happens then? Food isn't digested properly. The body doesn't absorb the nutrients it needs, especially fat and fat-soluble vitamins (like vitamins A, D, E, and K). This causes problems like stomach upset and weight loss.

But don't worry. There are now very good treatments for this. If you get the right treatment, you can live a normal life again.

What are the causes of EPI?

The main cause of EPI is some kind of damage to the pancreas. This can have several causes.

• Frequent pancreatitis: Doctors call this chronic pancreatitis . What happens here is that the enzymes produced in the pancreas start working inside the pancreas before they reach the small intestine. This damages the pancreas itself. This risk is higher in people who drink a lot of alcohol. Also, factors such as high blood fat levels (Triglycerides) and weak immune systems can also affect this.
• Surgery: This condition can sometimes be caused by surgery on the pancreas, stomach, or intestines.
• Congenital diseases: Some hereditary diseases can also cause EPI.
• Cystic Fibrosis: People with this disease produce thick, sticky mucus in their bodies. This mucus blocks the pancreatic ducts, preventing enzymes from getting out.
• Shwachman-Diamond Syndrome: This is also a genetic disease. In this condition, the cells that produce enzymes in the pancreas are lost.
• Other diseases: Some people are also at risk of developing EPI due to other diseases of the digestive system, such as Crohn's disease and Celiac disease.

How do you know if you have EPI? What are the symptoms?

In the early stages, there may be no symptoms, but as the pancreas is damaged and its ability to absorb fat decreases, symptoms gradually begin to appear.

The table below lists the most common symptoms.

How does the doctor diagnose this disease exactly?

When you go to see the doctor, he will ask you about your symptoms and then order several tests to confirm the diagnosis.

Questions to ask the doctor

• Do you have pain in your upper stomach?
• Does the stool have a bad smell or an oily texture? Is it difficult to wash away?
• Do you have diarrhea or bloating?
• Have you lost weight recently?

Tests that may be recommended

There are various types of tests for this.

What are the treatments?

The main and most effective treatment for EPI is Pancreatic Enzyme Replacement Therapy (PERT) . Simply put, it's taking pills to replace the enzymes your pancreas isn't producing.

• How to take PERT tablets: These tablets should be taken during meals . If taken before meals, the enzymes will have left the stomach before the food reaches it. If taken after meals, the enzymes will have arrived too late after the food has started to digest. Therefore, these tablets should be taken with main meals and snacks .
• Medications that reduce stomach acid: Sometimes, high stomach acid can destroy these enzyme pills before they can work. To stop this, your doctor may prescribe a medication like `Proton pump inhibitors` (e.g. omeprazole) or `H2 blockers` (e.g. famotidine).
• Painkillers: If there is pain, you can take a general painkiller like Paracetamol on the advice of your doctor. If the pain is severe, stronger medications may be prescribed. However, such medications can be addictive, so they should be used with extreme caution and under medical advice.

In addition, it is also very important to treat the underlying disease (e.g. Chronic Pancreatitis, Cystic Fibrosis) that caused the EPI condition.

How can you take care of yourself?

Along with medication, your lifestyle and eating habits are also very important in controlling this condition.

• Eat several small meals: Instead of eating three large meals a day, eat small meals about six times a day. This will make it easier to digest.
• Avoid alcohol and smoking: Alcohol makes it harder for the body to absorb fat and also damages the pancreas. Smoking is also harmful to the pancreas.
• Take vitamins: Since the body does not absorb them properly, you will have to take vitamins like vitamins A, D, E, and K externally. For this, your doctor will prescribe the appropriate vitamins and dosages.
• Seek advice from a nutritionist: It is very important to seek advice from a dietitian to prepare a nutritious diet that suits you.

EPI is not a condition to worry about. With the right treatment and lifestyle, you can definitely control it and live a normal life. The most important thing is to stay in touch with your doctor and follow his instructions exactly.