Understanding Causes Of Exocrine Pancreatic Insufficiency
Understanding Causes Of Exocrine Pancreatic Insufficiency Exocrine pancreatic insufficiency (EPI) is a condition that affects the pancreas, leading to the inadequate production of digestive enzymes. This deficiency can result in difficulties digesting food and absorbing nutrients properly. Understanding the causes of EPI is crucial for effective diagnosis and treatment.
One of the leading institutions in researching and treating EPI is the Acibadem Healthcare Group. Their expertise in pancreatic disorders and commitment to patient care make them a trusted resource in the field.
Pancreatic enzyme deficiency is closely associated with EPI. When the pancreas fails to produce enough enzymes, the body struggles to break down fats, proteins, and carbohydrates. This can lead to malabsorption and nutrient deficiencies.
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Additionally, we will delve into the impact of digestive enzyme deficiency, autoimmune diseases, alcohol abuse, cystic fibrosis, medications, and even pancreatic surgeries as potential causes of EPI. By examining these connections, we can gain valuable insights into the underlying reasons behind this condition.
Stay tuned as we uncover the intricate web of causes that contribute to exocrine pancreatic insufficiency. In gaining a comprehensive understanding of these factors, we can develop better strategies for early detection, diagnosis, and management.
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Pancreatic diseases play a significant role in the development of exocrine pancreatic insufficiency (EPI). Understanding the link between these diseases and EPI is crucial in comprehending the causes and potential preventive measures for this condition.
Pancreatitis
Pancreatitis, inflammation of the pancreas, is one of the leading causes of EPI. Acute pancreatitis, often triggered by gallstones or heavy alcohol consumption, can cause damage to the pancreatic tissue and impair its ability to produce enzymes for digestion. Chronic pancreatitis, characterized by long-term inflammation, can also lead to the gradual loss of pancreatic function and result in EPI.
Cystic Fibrosis
Cystic fibrosis, a genetic disorder, is another pancreatic disease associated with EPI. This life-threatening condition affects the normal functioning of the exocrine glands, including the pancreas. Individuals with cystic fibrosis often experience thickened mucus that blocks the pancreatic ducts, preventing the proper flow of digestive enzymes and leading to EPI.
Pancreatic Cancer
Pancreatic cancer, a malignant tumor that originates in the pancreas, can also cause EPI. As the tumor grows, it can obstruct the pancreatic ducts, hindering the release of enzymes necessary for food digestion. Additionally, cancer treatment such as surgery and radiation therapy can further impact pancreatic function, resulting in EPI.
Inherited Pancreatic Disorders
There are several inherited pancreatic disorders such as hereditary pancreatitis and Shwachman-Diamond syndrome that can predispose individuals to EPI. These genetic conditions disrupt the normal functioning of the pancreas, leading to EPI and digestive difficulties.
A table on Pancreatic Diseases and their Connection to EPI:
| Pancreatic Disease | Connection to EPI |
|---|---|
| Pancreatitis | Can cause damage to the pancreas, leading to EPI |
| Cystic Fibrosis | Thickened mucus blocks pancreatic ducts, causing EPI |
| Pancreatic Cancer | Obstruction of pancreatic ducts disrupts enzyme release, resulting in EPI |
| Inherited Pancreatic Disorders | Genetic conditions that affect pancreatic function, leading to EPI |
Understanding Malabsorption Causes
In individuals with exocrine pancreatic insufficiency (EPI), malabsorption is a common consequence that hinders the body’s ability to absorb essential nutrients. This section aims to explore the underlying causes of malabsorption, shedding light on the factors that contribute to this condition and its connection to EPI.
1. Pancreatic Enzyme Deficiency
A significant cause of malabsorption in EPI is the deficiency of pancreatic enzymes, including lipase, amylase, and protease. These enzymes are responsible for breaking down fats, carbohydrates, and proteins, respectively, enabling proper absorption in the gastrointestinal tract. When the pancreas fails to produce sufficient enzymes, it results in inadequate digestion of these nutrients and subsequent malabsorption.
2. Impaired Bile Production
Bile, produced by the liver and stored in the gallbladder, plays a vital role in the absorption of dietary fats. However, in some cases of EPI, impaired bile production can contribute to malabsorption. The insufficient supply of bile hampers the emulsification and breakdown of fat molecules, leading to their inadequate absorption by the body.
3. Intestinal Damage
Certain conditions, such as Crohn’s disease, celiac disease, and radiation enteritis, can cause damage to the intestinal lining. This damage disrupts the normal functioning of the small intestine, impairing the absorption of nutrients. In EPI, the already compromised digestive process exacerbates malabsorption, further hindering nutrient uptake.
4. Rapid Gastric Emptying
In some cases, individuals with EPI experience rapid gastric emptying, also known as dumping syndrome. This condition causes food to move too quickly from the stomach to the small intestine, resulting in poor digestion and insufficient absorption of nutrients. Rapid gastric emptying can contribute to malabsorption and various associated symptoms.
5. Small Intestinal Bacterial Overgrowth (SIBO)
SIBO refers to the excessive growth of bacteria in the small intestine, which can disrupt the absorption process. EPI patients may be more susceptible to SIBO due to the altered gut environment caused by pancreatic insufficiency. The presence of excessive bacteria in the small intestine can interfere with nutrient absorption, leading to malabsorption.
By understanding these malabsorption causes, we can gain valuable insights into the underlying reasons for EPI. Recognizing these factors allows healthcare professionals to tailor treatment plans and interventions to address both the pancreatic insufficiency and malabsorption, improving overall patient outcomes.
The Importance of Digestive Enzymes
In the context of exocrine pancreatic insufficiency (EPI), digestive enzymes play a crucial role in the proper digestion and absorption of nutrients. A deficiency in these enzymes can lead to EPI and contribute to its causes. Let’s explore the significance of digestive enzymes in more detail.
EPI and Digestive Enzyme Deficiency
Exocrine pancreatic insufficiency occurs when the pancreas fails to produce enough digestive enzymes, specifically lipase, protease, and amylase. These enzymes are responsible for breaking down fats, proteins, and carbohydrates, respectively. When there is a deficiency in these enzymes, the body cannot effectively digest food and absorb essential nutrients.
| Name of Enzyme | Function | Consequence of Deficiency |
|---|---|---|
| Lipase | Breaks down fats into fatty acids and glycerol | Impaired fat digestion and malabsorption |
| Protease | Breaks down proteins into amino acids | Incomplete protein digestion and nutrient deficiencies |
| Amylase | Breaks down carbohydrates into glucose | Inefficient carbohydrate digestion and malnutrition |
A deficiency in digestive enzymes can lead to a range of symptoms associated with EPI, including diarrhea, weight loss, malnutrition, and nutrient deficiencies. Without adequate enzyme activity, the body is unable to absorb essential nutrients, resulting in ongoing health complications if left untreated.
Treatment Options for Digestive Enzyme Deficiency
The management of EPI caused by digestive enzyme deficiency typically involves enzyme replacement therapy (ERT). This treatment involves taking supplemental digestive enzymes, usually in the form of pancreatic enzyme replacement capsules, with meals or snacks.
ERT aims to enhance the body’s ability to digest and absorb nutrients by providing the necessary enzymes that the pancreas is unable to produce in sufficient quantities. By restoring enzyme levels, ERT can help alleviate the symptoms associated with EPI and improve overall nutritional status.
In Summary
Digestive enzyme deficiency is an important factor in the development of exocrine pancreatic insufficiency (EPI). Understanding the significance of digestive enzymes and their role in proper digestion and absorption is crucial in managing and treating EPI effectively. With appropriate enzyme replacement therapy, individuals with EPI can regain their ability to digest and absorb essential nutrients, leading to improved health and well-being.
Genetic Factors and EPI
In addition to environmental and lifestyle factors, genetic predispositions can also play a role in the development of exocrine pancreatic insufficiency (EPI). Understanding the genetic factors associated with EPI can provide valuable insights into its causes and potential impacts on individuals.
Research has shown that mutations in certain genes can increase the risk of developing EPI. These genetic variations can affect the production and function of enzymes produced by the pancreas, leading to pancreatic insufficiency.
One such gene that has been implicated in EPI is the CTRC gene. Mutations in this gene have been found to disrupt the normal functioning of pancreatic enzymes, compromising the digestion and absorption of nutrients. This can result in the symptoms associated with EPI, such as weight loss, malnutrition, and gastrointestinal issues.
Another gene that plays a role in EPI is the SPINK1 gene. Mutations in this gene can lead to an overactive production of pancreatic enzymes, which can cause inflammation and damage to the pancreas. This can ultimately result in pancreatic insufficiency.
It is important to note that having a genetic predisposition to EPI does not guarantee that an individual will develop the condition. Factors such as lifestyle choices, environmental exposures, and other health conditions can also influence the manifestation of EPI.
EPI and Inherited Conditions
There are several inherited conditions that are known to increase the risk of developing EPI. These conditions include cystic fibrosis, Shwachman-Diamond syndrome, and Johanson-Blizzard syndrome.
Cystic fibrosis, in particular, is a genetic disorder that affects multiple organs, including the pancreas. The majority of individuals with cystic fibrosis will develop EPI due to the abnormalities in their pancreatic function.
Shwachman-Diamond syndrome and Johanson-Blizzard syndrome are both rare genetic disorders that affect various systems in the body, including the pancreas. These conditions can lead to the development of EPI and its associated symptoms.
Genetic Testing and EPI
Genetic testing can be a valuable tool in diagnosing the underlying causes of EPI. By identifying specific genetic mutations associated with EPI, healthcare providers can develop targeted treatment plans and provide personalized care for individuals with EPI.
This type of testing involves analyzing a person’s DNA to identify any genetic variations that may contribute to the development of EPI. It can help determine the overall risk of EPI and guide healthcare professionals in making informed decisions regarding treatment options.
Additionally, genetic testing can also be useful for identifying individuals who may be at risk for developing EPI in the future. This information can aid in early intervention and preventive measures to minimize the impact of EPI on an individual’s health and well-being.
In summary, genetic factors can contribute to the development of exocrine pancreatic insufficiency. Understanding these genetic predispositions is crucial in comprehending the causes of EPI and the potential implications for individuals. Genetic testing plays a vital role in diagnosing and managing EPI, allowing healthcare providers to provide personalized care and targeted treatment strategies.
Inflammatory Conditions and EPI
Inflammation plays a crucial role in the development of various diseases, including exocrine pancreatic insufficiency (EPI). In this section, we will explore the connection between inflammatory conditions and EPI, shedding light on the potential causes and implications of inflammation on pancreatic health.
The Impact of Inflammation
Inflammatory conditions, such as pancreatitis and autoimmune disorders, can cause damage to the pancreas, leading to EPI. When the pancreas becomes inflamed, it can disrupt the production and secretion of digestive enzymes, necessary for proper digestion and nutrient absorption.
Inflammation can result in the destruction of the pancreatic tissue responsible for producing these enzymes, impairing the organ’s functionality. As a result, individuals with inflammatory conditions may experience a deficiency in pancreatic enzymes, contributing to the development of EPI.
Understanding the Link
Research has demonstrated a strong association between inflammatory conditions and the onset of EPI. Chronic inflammation can lead to structural changes within the pancreas, affecting the exocrine function and ultimately resulting in pancreatic enzyme deficiency.
Additionally, recurrent episodes of inflammation can exacerbate pancreatic damage, further compromising the organ’s ability to produce and release digestive enzymes. This continuous cycle of inflammation and tissue destruction can perpetuate the progression of EPI.
Targeted Treatment Approaches
Managing inflammatory conditions is crucial in preventing or minimizing the development of EPI. Healthcare providers may recommend various treatment approaches to mitigate inflammation and protect pancreatic health.
These treatment strategies may include medications to reduce inflammation, lifestyle modifications to promote pancreatic healing, and managing underlying conditions that contribute to inflammation.
| Inflammatory Conditions | Potential Impact on EPI |
|---|---|
| Pancreatitis | Can lead to pancreatic tissue damage, impairing enzyme production |
| Autoimmune disorders (e.g., autoimmune pancreatitis, lupus) | Result in chronic inflammation, affecting pancreatic function |
| Inflammatory bowel disease (e.g., Crohn’s disease, ulcerative colitis) | Can cause systemic inflammation that affects pancreatic health |
While addressing the underlying inflammatory condition is essential, individuals with EPI may also require additional treatments to manage the enzyme deficiency and promote proper digestion and nutrient absorption.
By understanding the role of inflammatory conditions as a potential cause of EPI, healthcare professionals can implement targeted interventions to alleviate inflammation, protect pancreatic function, and improve the overall well-being of individuals with this condition.
Pancreatic Surgeries and EPI
Surgeries involving the pancreas can sometimes result in exocrine pancreatic insufficiency (EPI). These procedures, while necessary for various conditions, can lead to a disruption in the normal functioning of the pancreas and affect the production and secretion of digestive enzymes. As a result, individuals may experience difficulties in properly digesting and absorbing nutrients.
It is important to note that not all pancreatic surgeries result in EPI. The likelihood of developing EPI after a procedure depends on several factors, including the extent of surgical intervention, the portion of the pancreas affected, and the overall health of the individual.
One of the primary reasons why pancreatic surgeries can cause EPI is the removal or damage to the pancreatic tissue responsible for producing digestive enzymes. This can lead to a decreased production of enzymes and a subsequent deficiency, hindering the process of breaking down food in the digestive system.
Furthermore, surgical trauma to the pancreas can result in scarring and inflammation, affecting the normal functioning of the organ. Inflammation can disrupt the pancreatic ducts, which transport enzymes from the pancreas to the small intestine. Any blockage or narrowing of these ducts can impair the delivery of digestive enzymes, further exacerbating the risk of EPI.
While surgeons take precautionary measures to minimize the risk of EPI during pancreatic surgeries, it is still important for individuals to be aware of the potential consequences and seek appropriate medical care if symptoms of EPI arise following a procedure.
EPI Risk Factors Following Pancreatic Surgeries
Several factors can increase the risk of developing EPI after a pancreatic surgery:
- The extent of pancreatic tissue removal or damage during the surgery.
- The location of the surgical intervention within the pancreas.
- Prior history of pancreatic disease or conditions affecting pancreatic function.
- Underlying conditions that may affect pancreatic healing and recovery.
- The overall health and age of the individual undergoing the surgery.
By considering these risk factors, healthcare professionals can better identify individuals who may be at a higher risk of developing EPI after pancreatic surgeries. Early detection and appropriate management of EPI can help individuals regain digestive function and prevent complications associated with malabsorption.
Autoimmune Diseases and EPI
Exocrine pancreatic insufficiency (EPI) can be influenced by autoimmune diseases that affect the pancreas. These conditions disrupt the normal functioning of the pancreas, leading to a deficiency in pancreatic enzymes and subsequent EPI.
Autoimmune diseases occur when the immune system mistakenly targets and attacks the body’s own tissues. In the case of EPI, the immune system may attack the cells within the pancreas responsible for producing and releasing digestive enzymes.
Examples of autoimmune diseases that can contribute to EPI include:
- Rheumatoid arthritis
- Lupus
- Celiac disease
- Autoimmune pancreatitis
These conditions can lead to inflammation and damage to the pancreas, impairing its ability to produce sufficient enzymes for digestion. As a result, individuals with autoimmune diseases may experience symptoms such as abdominal pain, diarrhea, and weight loss, which are characteristic of EPI.
It is important for individuals with autoimmune diseases to be aware of the potential link to EPI and monitor their pancreatic health. Early detection and management of EPI can help improve quality of life and prevent complications associated with malabsorption and inadequate nutrient absorption.
Consulting with a healthcare provider experienced in treating both autoimmune diseases and EPI is crucial for proper diagnosis and management. Through a combination of medication, dietary changes, and enzyme replacement therapy, individuals with autoimmune-related EPI can effectively manage their condition and improve overall health.
| Autoimmune Disease | Pancreatic Impact |
|---|---|
| Rheumatoid arthritis | Inflammation and damage to the pancreas, affecting enzyme production |
| Lupus | Autoimmune attack on pancreatic cells, leading to enzyme deficiency |
| Celiac disease | Immune response damages the pancreas, hindering enzyme production |
| Autoimmune pancreatitis | Autoimmune response causes inflammation and disruption of pancreatic function |
Alcohol Abuse and EPI
Chronic alcohol abuse can have detrimental effects on the pancreas, potentially leading to exocrine pancreatic insufficiency (EPI). The pancreas plays a vital role in producing digestive enzymes that aid in the breakdown of food. Alcohol abuse can disrupt the normal functioning of the pancreas, causing inflammation and damage to the pancreatic tissues.
Alcohol-induced pancreatitis is a condition characterized by inflammation of the pancreas due to excessive alcohol consumption. This inflammatory response can impair the pancreas’s ability to produce and release digestive enzymes, resulting in EPI. Over time, the repeated damage to the pancreatic cells can lead to permanent impairment and the development of EPI.
It is important to note that not all individuals who abuse alcohol will develop EPI. However, chronic and excessive alcohol consumption increases the risk significantly. Studies have shown that prolonged alcohol abuse can disrupt the secretion of digestive enzymes and damage the acinar cells responsible for their production, both of which are crucial factors in the development of EPI.
In addition to directly affecting pancreatic function, alcohol abuse can also contribute to the development of other pancreatic diseases that are associated with EPI. Chronic alcohol consumption is a known risk factor for conditions such as alcoholic pancreatitis and alcoholic cirrhosis, both of which can lead to exocrine pancreatic insufficiency.
In summary, chronic alcohol abuse can have severe consequences for the pancreas, increasing the risk of developing exocrine pancreatic insufficiency. The disruption of pancreatic function, inflammation, and damage to the pancreatic tissues caused by alcohol can all contribute to the development of EPI. It is crucial for individuals struggling with alcohol abuse to seek help and address their alcohol consumption to mitigate the risk of EPI and other pancreatic diseases.
The Impact of Cystic Fibrosis on EPI
Cystic fibrosis, a genetic disorder that primarily affects the lungs and digestive system, can have a profound impact on the pancreas and contribute to the development of exocrine pancreatic insufficiency (EPI). In this section, we will explore how cystic fibrosis affects the pancreas, leading to EPI, and delve into its underlying causes.
The Role of Cystic Fibrosis in Pancreatic Dysfunction
Cystic fibrosis is caused by a mutation in a gene called the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This mutation leads to the production of a defective protein that affects the movement of salt and water in and out of cells, resulting in thick, sticky secretions in various organs, including the pancreas.
Within the pancreas, the CFTR protein is responsible for regulating the flow of digestive enzymes, such as amylase, lipase, and protease, into the intestines. These enzymes are crucial for breaking down carbohydrates, fats, and proteins, allowing for proper absorption and digestion of nutrients.
In individuals with cystic fibrosis, the defective CFTR protein disrupts the normal functioning of the pancreas, leading to a deficiency in digestive enzymes. This deficiency impairs the digestive process, resulting in malabsorption of nutrients and the development of EPI.
Additional Factors Contributing to EPI in Cystic Fibrosis
While the CFTR gene mutation is the primary cause of pancreatic dysfunction in cystic fibrosis, other factors can worsen the severity of EPI. These factors include:
- Pancreatic inflammation: Inflammation in the pancreas, known as pancreatitis, can further damage the pancreatic tissue and exacerbate the symptoms of EPI.
- Pancreatic fibrosis: Over time, the ongoing inflammation and damage to the pancreas can lead to the formation of scar tissue, impairing its ability to produce and release digestive enzymes.
- Persistent infections: Infections in the pancreas, such as recurrent episodes of pancreatitis, can contribute to the progression of EPI in individuals with cystic fibrosis.
It’s important to note that the severity of EPI in individuals with cystic fibrosis can vary. Some may experience mild symptoms, while others may have more pronounced digestive issues and nutrient malabsorption.
Managing EPI in Cystic Fibrosis
Although there is no cure for cystic fibrosis or EPI, various treatment strategies can help manage the symptoms and improve quality of life for individuals with this condition. Treatment options for EPI in cystic fibrosis may include:
- Supplemental pancreatic enzyme replacement therapy (PERT): This involves taking oral pancreatic enzyme supplements to replace the digestive enzymes that the pancreas is unable to produce. PERT helps improve nutrient absorption and digestion.
- Dietary modifications: A well-balanced, nutrient-dense diet is essential for individuals with EPI and cystic fibrosis. Working with a registered dietitian can help develop a personalized meal plan to ensure adequate nutrient intake.
- Vitamin and mineral supplementation: Certain vitamins and minerals, such as fat-soluble vitamins (A, D, E, and K) and zinc, may be poorly absorbed in individuals with EPI. Supplementation may be necessary to prevent deficiencies.
By effectively managing EPI in individuals with cystic fibrosis, healthcare professionals can help minimize symptoms, optimize nutritional status, and support overall well-being.
| Factors Contributing to EPI in Cystic Fibrosis | Description |
|---|---|
| Pancreatic inflammation | Inflammation in the pancreas, known as pancreatitis, can further damage the pancreatic tissue and exacerbate the symptoms of EPI. |
| Pancreatic fibrosis | Over time, the ongoing inflammation and damage to the pancreas can lead to the formation of scar tissue, impairing its ability to produce and release digestive enzymes. |
| Persistent infections | Infections in the pancreas, such as recurrent episodes of pancreatitis, can contribute to the progression of EPI in individuals with cystic fibrosis. |
Medications and EPI
Certain medications can have a significant impact on the functioning of the pancreas, potentially leading to the development of exocrine pancreatic insufficiency (EPI). It is important to understand the connection between specific medications and the causes of EPI to ensure effective treatment and management.
EPI causes:
- Medications that can affect the functioning of the pancreas
- Potential link between medication usage and EPI development
There are various medications that have been associated with an increased risk of EPI. These medications can interfere with the normal production and secretion of pancreatic enzymes, resulting in a deficiency that leads to EPI. It is important for healthcare providers to be aware of these potential risks and closely monitor patients who are taking these medications.
Some commonly prescribed medications that have been linked to the development of EPI include:
- Proton pump inhibitors (PPIs): These medications are commonly used to reduce stomach acid production and treat conditions such as ulcers and gastroesophageal reflux disease (GERD). Long-term use of PPIs has been associated with an increased risk of EPI.
- Chemotherapy drugs: Certain chemotherapy drugs can cause damage to the pancreas, leading to EPI. Patients undergoing cancer treatment should be monitored for pancreatic function.
- Antibiotics: Some antibiotics, particularly those in the fluoroquinolone class, have been linked to the development of EPI. These medications can disrupt the balance of bacteria in the gut, affecting pancreatic enzyme production.
It is important for patients to discuss the potential risks and side effects of medications with their healthcare provider. If EPI is suspected or diagnosed, adjustments to medication regimens may be necessary to manage the condition effectively. Monitoring pancreatic enzyme levels and providing appropriate treatment are crucial in preventing complications and improving quality of life for individuals with EPI.
Summary and Conclusion
 From pancreatic diseases to malabsorption, genetic factors to inflammatory conditions, a range of factors can contribute to the development of EPI.
We have discussed the importance of digestive enzymes in the context of EPI, highlighting how a deficiency in these enzymes can lead to digestive problems and malabsorption. Additionally, we have examined the role of alcohol abuse, autoimmune diseases, medications, and cystic fibrosis in causing pancreatic insufficiency.
Early detection and diagnosis of EPI are crucial for effective management. By understanding the underlying causes, healthcare providers can develop targeted treatment plans to alleviate symptoms and improve patients’ quality of life. It is essential for individuals experiencing symptoms such as chronic diarrhea, weight loss, and abdominal pain to consult a healthcare professional, as prompt intervention can lead to better outcomes.
In conclusion, a combination of factors, including various pancreatic diseases, malabsorption, genetic predispositions, autoimmune diseases, alcohol abuse, medications, and cystic fibrosis, can contribute to exocrine pancreatic insufficiency. By addressing these causes and implementing appropriate treatments, individuals with EPI can manage their condition and lead healthier lives.
FAQ
What are the causes of exocrine pancreatic insufficiency?
Exocrine pancreatic insufficiency (EPI) can be caused by various factors, including pancreatic diseases such as chronic pancreatitis, cystic fibrosis, and pancreatic cancer. Other causes include genetic factors, autoimmune diseases, alcohol abuse, certain medications, and surgical procedures involving the pancreas.
How does the Acibadem Healthcare Group contribute to the understanding and treatment of EPI?
The Acibadem Healthcare Group is actively involved in researching and treating exocrine pancreatic insufficiency. Through their expertise and advancements in the field, they contribute to a better understanding of the condition and provide effective treatment options to patients.
What is the connection between EPI and pancreatic enzyme deficiency?
Exocrine pancreatic insufficiency (EPI) is characterized by the insufficient production or release of digestive enzymes by the pancreas. This deficiency in pancreatic enzymes leads to impaired digestion and absorption of nutrients, resulting in malabsorption and other symptoms associated with EPI.
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