Pancreatic Insufficiency

Excerpt

The pancreas is a soft, finely lobulated retroperitoneal gland on the posterior abdominal wall performing endocrine and exocrine functions. This organ is essential for the digestion, absorption, and metabolism of carbohydrates, fats, and proteins. Exocrine pancreatic insufficiency (EPI) is a reduction in pancreatic enzyme activity (primarily pancreatic lipase) within the intestinal lumen below the threshold required for digestive functions. EPI may result from inadequate stimulation of secretion, reduced acinar enzyme secretion, obstruction of the pancreatic duct outflow, or inadequate mixing of pancreatic enzymes with ingested food.

Patients with EPI commonly present with steatorrhea, flatulence, weight loss, and abdominal pain of variable location and severity. EPI is associated with impaired quality of life, increased risk of complications due to malnutrition, low bone mineral density, and functional decline. While pancreatic malfunction could affect both endocrine and exocrine functions of the pancreas, the term pancreatic insufficiency usually refers to exocrine rather than endocrine deficiency.