May EPI Be Inflicting Your Unexplained GI Signs?

Should you’re suffering from mysterious gasoline, bloating, and diarrhea, you might need exocrine pancreatic insufficiency (EPI), which happens when the pancreas lacks the enzymes to correctly digest the meals you eat. You’re extra prone to EPI in case you have sure well being situations, together with power pancreatitis, celiac illness, diabetes, cystic fibrosis, or pancreatic most cancers, says Steven Gillon, DO, a specialist in digestive ailments at Holy Title Medical Heart in Teaneck, New Jersey.

One other threat issue is pancreatic surgical procedure: In response to a overview printed in April 2020 within the World Journal of Gastrointestinal Pathophysiology, EPI is a standard complication of pancreatic surgical procedure that’s typically underdiagnosed and undertreated. Individuals who have a historical past of alcohol abuse are additionally at increased threat of EPI.

Medical doctors possible don’t consider EPI as typically as they need to, in line with Dr. Gillon. As a result of EPI and different digestive situations share some signs, it may be difficult to diagnose. However, getting the right prognosis is necessary. EPI could cause signs that may have a destructive affect on high quality of life and result in probably life-threatening issues, akin to malnutrition and heart problems, in line with analysis.

In case your physician suspects you might have EPI, they are going to possible take blood and stool samples and order assessments, in line with the World Journal of Gastrointestinal Pathophysiology overview.

The excellent news is that the situation is treatable with pancreatic enzyme alternative remedy (PERT) and vitamin dietary supplements, so it’s necessary to remain conscious of widespread EPI signs.

Diarrhea

Diarrhea generally is a symptom of many illnesses. However, power diarrhea accompanied by sudden, unexplained weight reduction and an general change in bowel habits ought to elevate your suspicions, says Benjamin Lebwohl, MD, a gastroenterologist and affiliate professor of drugs at Columbia College Medical Heart in New York Metropolis.

Steatorrhea

One thing else to look at for is steatorrhea, that are foul-smelling, oily stools (which float, persist with the edges of the bathroom bowl, and are laborious to flush) that may be particularly worse after consuming fatty meals. It is a particular signal of EPI, and it’s best to notify your physician if you happen to expertise it, says Khalid Khan, MD, a gastroenterologist and the medical director of the Islet Cell Transplant Program at MedStar Georgetown Transplant Institute in Washington, DC.

Stomach Ache

Stomach ache is one other symptom of many gastrointestinal issues, as is bloating within the stomach. With EPI, you’ll really feel that ache extra while you eat, particularly with fatty meals, Dr. Lebwohl says. The signs of diarrhea and abdomen ache are additionally related to irritable bowel syndrome (IBS), a extra widespread situation than EPI. In youthful folks, these signs usually tend to be IBS, Dr. Khan says, however for folks 60 or older, notably if they’ve diabetes, EPI is a larger chance.

Unexplained Weight Loss and Fatigue

If you end up dropping kilos and also you’re undecided why, plus you’ve got abdomen ache and fatigue, focus on the opportunity of EPI together with your physician, Gillon says. EPI prevents correct digestion of meals, so folks with EPI sometimes must eat a nutrient-rich weight loss plan as a part of their therapy, together with pancreatic enzyme alternative remedy, in line with The Nationwide Pancreas Basis (NPF).

Vitamin Deficiency

When you have EPI, your physique doesn’t correctly digest meals, so that you’ll have hassle absorbing sure vitamins, together with the important thing fat-absorbable nutritional vitamins A, D, E, and Okay, Gillon says. That’s why some folks with EPI expertise bone loss (osteoporosis) and different well being points associated to a scarcity of those nutritional vitamins, in line with a overview printed in February 2023 within the World Journal of Gastroenterology. In truth, many individuals with EPI want dietary supplements to assist keep acceptable ranges of those nutritional vitamins, says the NPF.

When to Name a Physician

Should you’re experiencing a mixture of widespread EPI signs, name your physician. Earlier than your appointment, monitor your signs — once they happen and in the event that they’ve modified over time. Do not forget that fats in your stools is the traditional symptom of EPI, versus different digestive situations. “It’s necessary to be conscious of your signs and never ignore or reduce them if there’s a major change,” Lebwohl says. “If an individual is at elevated threat of EPI, prognosis and therapy may end up in a serious enchancment in high quality of life.” Along with therapy with PERT and vitamin dietary supplements, your physician also can show you how to make more healthy life-style selections, akin to bettering your weight loss plan, avoiding alcohol, and never smoking.