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Symptoms & Causes for Exocrine Pancreatic Insufficiency - NIDDK

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href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/diagnosis">Diagnosis</a> </li> <li class="ln-collapsed"> <a href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/treatment">Treatment</a> </li> <li class="ln-collapsed"> <a href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/eating-diet-nutrition">Eating, Diet, &amp; Nutrition</a> </li> <li class="ln-collapsed"> <a href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/clinical-trials">Clinical Trials</a> </li> </ul> </nav> <article class="dk-content"> <h1 itemprop="name">Symptoms & Causes for Exocrine Pancreatic Insufficiency</h1> <div class="health-detail-content"> <h2 id="whatsymptomsepi">What are the symptoms of EPI?</h2> <p>Symptoms of <a href="/health-information/digestive-diseases/exocrine-pancreatic-insufficiency/definition-facts#whatisepi">exocrine pancreatic insufficiency (EPI)</a>&nbsp;may include</p> <ul> <li><a href="/Dictionary/B/bloating" class="dictionary-term">bloating</a></li> <li>cramps, discomfort, or pain in the <a href="/Dictionary/A/abdomen" class="dictionary-term">abdomen</a></li> <li><a href="/health-information/digestive-diseases/diarrhea">diarrhea</a></li> <li>loose, greasy, bad-smelling <a href="/Dictionary/S/stool" class="dictionary-term">stools</a></li> <li>passing excess <a href="/health-information/digestive-diseases/gas-digestive-tract">gas</a>, or <a href="/Dictionary/F/flatulence" class="dictionary-term">flatulence</a></li> <li>weight loss</li> </ul> <p>In rare cases, EPI may lead to problems seeing at night or problems with your bones, such as <a href="https://medlineplus.gov/bonedensity.html">low bone mass</a> or <a href="https://medlineplus.gov/osteoporosis.html">osteoporosis</a>.</p> <h2 id="whatcausesepi">What causes EPI?</h2> <span class="figure medium right"><img height="1000" alt="Woman clutching her stomach." width="667" src="/-/media/Images/Health-Information/Digestive-Diseases/woman-clutching-stomach_667x1000.jpg" /><span class="figcaption"><span class="caption">Symptoms of EPI may include cramps, discomfort, or pain in the abdomen.</span></span></span> <p>Common causes of EPI include</p> <ul> <li><a href="/Dictionary/C/chronic" class="dictionary-term">chronic</a> and <a href="/Dictionary/A/acute" class="dictionary-term">acute</a>&nbsp;<a href="/health-information/digestive-diseases/pancreatitis">pancreatitis</a></li> <li><a href="https://medlineplus.gov/cysticfibrosis.html">cystic fibrosis</a></li> <li><a href="https://www.cancer.gov/types/pancreatic">pancreatic cancer</a></li> <li>surgery of the pancreas or <a href="/Dictionary/U/upper-GI-tract" class="dictionary-term">upper gastrointestinal tract</a></li> </ul> <p>Less common causes of EPI include</p> <ul> <li><a href="/health-information/diabetes/overview">diabetes</a>—type 1 and type 2</li> <li>untreated <a href="/health-information/digestive-diseases/celiac-disease">celiac disease</a></li> <li><a href="/Dictionary/I/inflammatory-bowel-disease" class="dictionary-term">inflammatory bowel disease</a>, including <a href="/health-information/digestive-diseases/crohns-disease">Crohn’s disease</a>&nbsp;and <a href="/health-information/digestive-diseases/ulcerative-colitis">ulcerative colitis</a></li> <li><a href="https://medlineplus.gov/hivaids.html">HIV</a></li> <li>rare genetic disorders, such as <a href="https://medlineplus.gov/genetics/condition/shwachman-diamond-syndrome/">Shwachman-Diamond syndrome</a> and <a href="https://rarediseases.info.nih.gov/diseases/80/johanson-blizzard-syndrome">Johanson-Blizzard syndrome</a></li> <li><a href="/health-information/digestive-diseases/zollinger-ellison-syndrome">Zollinger-Ellison syndrome</a></li> </ul> </div> <div class="dk-review-date">Last Reviewed January 2023</div> <div id="aa4e5e89b4764cb6930e1e1834b86989" class="dk-share"> <span>Share<span 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