How is EPI diagnosed?

Your doctor may be able to diagnose EPI (exocrine pancreatic insufficiency) based on your medical history and symptoms. So, if you think you could have EPI, the first step you should take is to talk to your doctor. Because EPI can sometimes be difficult to diagnose, it’s important that you open up and be as specific about your symptoms as possible.

When you talk to your doctor, remember to share the following information:

  • Any conditions or procedures in your medical history (not just a pancreatic insufficiency diagnosis)
  • Your eating habits and diet
  • If you drink alcohol or smoke
  • Any and all symptoms you’ve been experiencing and the frequency and severity of your symptoms
  • When your symptoms started
  • If you’ve had unexplained weight loss
  • Any differences in your stools and bowel movements
  • Any medications or herbal supplements you may be taking
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Who can diagnose EPI?

Primary care doctors may be able to diagnose EPI. However, in some cases, they may refer patients to a specialist—usually a gastroenterologist. Gastroenterologists specialize in disorders of the gastrointestinal tract, which includes the stomach, intestines, pancreas, liver, and gallbladder.

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The 3 main tests that are used to help confirm an EPI diagnosis

While doctors can often diagnose EPI based on medical history and symptoms, they may decide to use a test to confirm a diagnosis. Several different types of tests can be performed, some of which use stool samples.

Fecal elastase test

This test measures the amount of elastase, an enzyme produced by the pancreas, in your stool. A deficiency of elastase could be an indicator of EPI. It may be harder to diagnose milder EPI using this test.

Fecal fat test

This test checks the amount of fat in your stool to help determine how much your body is not absorbing. It can also reveal evidence of steatorrhea (foul-smelling, oily stools). Some people find this test to be difficult because it requires eating a prescribed diet and collecting and handling stool samples over 3 days.

Pancreatic function test

This type of test is considered the most accurate way to assess the exocrine function of your pancreas. It involves inserting a tube into your small intestine to collect pancreatic secretions. This test is usually performed only at specialized centers and its use is limited.

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Answers to frequently asked questions

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EPI treatment and management

Your doctor may include prescription treatment, vitamin supplements, and diet and lifestyle adjustments in your EPI management plan.