Exocrine Pancreatic Insufficiency: A Literature Review

Abstract

Exocrine pancreatic insufficiency (EPI) is a clinical entity that manifests as a mal absorption syndrome. Its relationship with multiple worldwide-highly prevalent pancreatic and extra pancreatic affections constitutes a major health problem due to high morbidity and mortality rates. The underlying disease requires an exhaustive assessment to identify possible nutritional deficiencies so as to prevent future complications. An impaired hydro electrolytic balance and low levels of serum nutritional markers indicate or predict EPI in high risk subjects. Unfortunately, pancreatic exocrine function test available so far do not diagnose early stages of the disease but they are quite effective in advanced EPI. Imaging studies are essential in the overall management of EPI as they may provide information regarding the etiology and structural pancreatic modifications. ERCP, despite post-procedure complications, is considered the gold standard due to its diagnostic and therapeutic properties. Treatment is based on pancreatic enzyme replacement therapy (PERT) along with nutritional supplements intake and good control of the underlying disease.