How is Exocrine Pancreatic Insufficiency (EPI/PEI) Diagnosed?

[@starrleo12]

He just gave me my diagnosis within the first minute of the video!

[@dancethenightaway70]

Thank Dr Freedman for all your posts that are very informative and help people like myself to manage my EPI better. I’m glad you recommend having diabetes checked and how this can result in Epi. Many people don’t understand the exocrine and endocrine difference that make up the pancreas.

[@johnapple784]

Thank you for highlighting this area! There are few doctors that really understand the impact of EPI. Dr. Freedman also has an in depth article on Exocrine Pancreatic Insufficiency written with Dr. Struyvenberg that anyone with EPI should read. Another really helpful resource was the book Primal Pancreas.

[@imtryinghere1]

Best video on epi on KZbin. Concise and detailed

[@MissionCure]

Thank you! We're glad you found this EPI video helpful.💙

[@dietcoke70]

Thank you so much for all the information and help ! I’m diabetic type one and have recently been diagnosed with EPI (I have no symptoms except for moderate progressive weight loss + elastase at 160) I’ve tried creon 25k before meals as recommended but it has only given me side effects especially changes in blood sugar (specifically random hypoglycemia) which complicates the management of diabetes itself…… so i stopped taking it and i’m afraid of trying it again for that same reason… I guess my question is : how can we explain or understand the mechanism of creon on blood sugar ? Is there anything I can do to avoid this side effect ? I really want to treat my condition and not keep avoiding treatment but with diabetes it’s difficult. It seems like I have to « choose » between one of them… Thank you in advance for your help.

[@MissionCure]

We're glad the video was helpful! Unfortunately, low or high blood sugar is listed as a side effect of Creon. Managing blood sugar on top of EPI is definitely tough. We recommend talking to your doctor more about this, as they may have more insight into your specific situation. This could include dietary changes and additional medication, depending on your needs. For more information on PERT, please visit: mission-cure.org/managing-pancreatitis/pancreatic-enzyme-replacement-therapy/

[@karunamayiholisticinc]

I was also diagnosrd with bile salt malabsorption in receng gut repprt and malfunctioning renin angiotensin pathway

[@tarabutler7997]

Thank you ❤

[@andrewsharongolding8139]

I was diagnosed with EPI after a low fecal elastase test (72) last year, and I have been on PERT since then. I had been suffering from chronic IBS, diarrhea, weight loss, bloating, abdominal pain, and the PERT (Zenpep) seems to be helping with these symptoms, although I still have trouble maintaining weight and have occasional abdominal pain in the right side of my abdomen, below the rib cage and above the navel. I recently had my elastase retested, and my numbers are now above 400. My question is: was I misdiagnosed due to the poor stool quality of the first test, or can I still have EPI even with elastase numbers in the normal range? I've had multiple CTs, an abdominal ultrasound, PET scans and an MRI. No abnormalities were found. I plan to stay on PERT, but I'd sure like to know the hows and whys of my condition. My PHP was unaware of EPI until my case.

[@MissionCure]

Poor stool quality can impact fecal elastase test results-a solid sample is typically needed for accuracy. Identifying the underlying cause of EPI is key, so we recommend discussing this with your doctor. You may find our Diagnosis Toolkit [ mission-cure.org/pancreatitis-diagnosis-toolkit/ ] and EPI playlist helpful for exploring potential causes and managing EPI: [ kzbin.info/aero/PLJXha4Nvx8NJRu03C4kOj3CyoqjvB_Q6u&feature=shared ]. Wishing you the best on your journey! 💙

[@wendyfulton6922]

I have not had a formed stool for years? What can I do?

[@MissionCure]

It’s important to work with a specialist who can do a thorough evaluation to find the root cause and recommend appropriate treatment. Our Diagnosis Toolkit can help guide conversations with your doctor: mission-cure.org/pancreatitis-diagnosis-toolkit/ You might also find our page on PERT helpful: mission-cure.org/managing-pancreatitis/pancreatic-enzyme-replacement-therapy/ Wishing you the best on your journey to answers! 💙

[@katrytter7979]

Curious is you can have upper left chest pain radiating to back and shortness of breath?

[@MissionCure]

Pancreatitis pain can vary and often radiates to the back, though each person’s experience is different. For more information and tips on managing pancreatitis pain, check out our webpage on pain management: mission-cure.org/managing-pancreatitis/pain-management/

[@karunamayiholisticinc]

The blood test isn't reliable then why does my doctor doesn't take seriously my fecal elastass test which is only 15 when it is meant to be over 200?

[@karunamayiholisticinc]

Or I m being ignored. Blood test is not reliable but the gold standard test is ignored in my case.

[@StaceyHurley-o4l]

I never have a formed stool. How to test?

[@dancethenightaway70]

Stool test must be a formed stool or it will always come back low.

[@MissionCure]

To test for Exocrine Pancreatic Insufficiency (EPI), it’s best to consult with a doctor. They might recommend a fecal elastase test and possibly a 72-hour fecal fat test. Additionally, blood tests for vitamin deficiencies and imaging studies like CT or MRI scans of the pancreas might be needed. A specialist can help determine if your loose stools are due to EPI or another underlying cause. Sometimes, they may treat it with Pancreatic Enzyme Replacement Therapy (PERT) to observe the response and then order a test on a formed stool. Hope this helps!

[@dawn6954]

Recently diagnosed with this but omg the medicine is $900/month with insurance! I cant afford it! :(

[@dancethenightaway70]

Creon has a assistance program which include vitamin and mineral supplements.

[@dawn6954]

@@dancethenightaway70 omg THANK YOU!!!

[@MissionCure]

You can find information on PERT savings programs here: mission-cure.org/pancreatitis-resources-and-support/ Hope this helps!

[@chetnajaiswal75]

I hv chronic pancreatitis since 11 yrs i am 30 yr old and my epi is 3.. doctor recommended me creon 25k 3 times a day..us it right dose? Or should i increase the dose? How many tablets a dase i need to take

[@MissionCure]

We're sorry to hear that. Dosing pancreatic enzymes is dependent on things like your body weight, how much fat your eating in a meal, and how large your meal is. For more information, check out this video: kzbin.info/www/bejne/b3TUn2ariN12iNUsi=EcKF2wmjL0PWP7Br or visit: mission-cure.org/exocrine-pancreatic-insufficiency/.

[@chetnajaiswal75]

​​@@MissionCure as i told u i have cp from 11 yrs now i diagnosed with epi.. can u pls tell me if someone diagnosed with epi it means his/her pancreas is 90% damaged? Is this true?

[@MissionCure]

@@chetnajaiswal75 Chronic pancreatitis is a progressive disease, and most patients will have some degree of EPI as their condition worsens. The relationship between CP, EPI, and pancreatic damage can vary from patient to patient, and the pancreas does not need to be 90% damaged for EPI to occur. For more information about EPI and pancreatitis, we encourage you to visit: mission-cure.org/exocrine-pancreatic-insufficiency/

[@chetnajaiswal75]

@@MissionCure thank you

[@chetnajaiswal75]

​@@MissionCure hlo. I m trying to conceive soon and i have cp and epi both.there is no video about pregnancy with cp and epi.. i will definitely talk to my doctor but can you say is it difficult for me to conceive as i have epi..is it dangerous for me?

[@IrfanRahman-h7j]

Is this cancer?

[@MissionCure]

It’s a common concern, but pancreatitis is not the same as pancreatic cancer. Pancreatitis occurs when the pancreas is inflamed, while pancreatic cancer involves tumor growth in the pancreas. For more details, check out our FAQ on pancreatitis and pancreatic cancer: mission-cure.org/complications-of-chronic-pancreatitis/pancreatitis-and-pancreatic-cancer/ Consider using our Diagnosis Toolkit to discuss your concerns with a specialist: mission-cure.org/pancreatitis-diagnosis-toolkit/ Hope this helps! 💙