Pancreatic Exocrine Insufficiency (PEI)

What is pancreatic exocrine insufficiency (PEI)

Pancreatic Exocrine Insufficiency (PEI) is a condition that causes problems in how you digest food. Your pancreas doesn’t make enough of the enzymes that your body needs to break down and absorb nutrients.

Enzymes speed up chemical reactions in the body. The enzymes made by the pancreas move into the small intestine, where they help break down the food that you have eaten.

When you have PEI, you don’t get the nutrition you need because your body can’t absorb fats and some vitamins and minerals from foods.

There are drugs that work for this condition that give you much needed supply of enzymes. Besides taking medicine, you can manage your symptoms by making sure you follow the right diet. Your doctor will recommend foods that will help you get enough nutrients and protein that you might be missing.

Signs & Symptoms of pancreatic exocrine insufficiency (PEI)

You may not have any symptoms at first. But once your pancreas gets so damaged that it starts to negatively affect your ability to absorb fats, you may experience the following:

  1. Pain or tenderness in your belly
  2. Foul-smelling bowel movements
  3. Diarrhea
  4. Gas and bloating
  5. Feeling full

You might also lose weight among other things, because your body doesn’t absorb enough vitamins. For instance, you could develop a bleeding disorder if you’re not getting enough vitamin K. Or you could get bone pain if you don’t get enough vitamin D.

Risk Factors of pancreatic exocrine insufficiency (PEI)

Your doctor will investigate a diagnosis of PEI If you have a new diagnosis of pancreatic disease or a new diagnosis of a condition that may predispose to PEI or malabsorption, including:

  • Chronic Pancreatitis (CP)
  • Type 1 Diabetes
  • Unresponsive celiac disease
  • HIV/AIDS
  • If you are current or former smokers
  • Longstanding history of alcohol abuse (defined as >5 drinks/day)
  • The last two risk categories interact, such that risk of PEI with alcohol abuse is heightened among current smokers

PEI will be investigated if you have any of the unexplained suggestive symptoms, even in the absence of the conditions just mentioned.

PEI is occasionally confused with some other GI conditions, such as peptic ulcers, Crohn’s and IBS, since they have many of the same symptoms. If you’re showing some of these symptoms, it is important to speak to your doctor to determine whether you have PEI or another GI condition.

Treating pancreatic exocrine insufficiency (PEI)

  • PERTs: Apart from a healthy diet, the main treatment for PEI is pancreatic enzyme replacement therapy (PERT). You take prescription pills that replace the enzymes your pancreas isn’t making. These enzymes break down your food so you can more easily digest and absorb it. You must take them during or immediately after your meals. If you take them before you eat, the replacement enzymes may move through your stomach before your food gets there.
  • Antacid: You may also need to take an antacid – called a proton-pump-inhibitor – to keep your stomach from breaking down pancreatic enzymes before they can start to work. This is only needed for certain types of PERT; check with your pharmacist if you are unsure. Together with your doctor, you should be able to come up with a treatment plan that works for you, so you can get back to living your life, your way!

Managing pancreatic exocrine insufficiency (PEI)

The right diet is very important for managing PEI. Your doctor and/or dietician can help you choose the foods that keep your energy level up and give you the nutrition you need. Here are a few tips:Don’t do this:

  • DON’T drink alcohol: It can make it even harder for your body to absorb fat, and can damage your pancreas over time.
  • DON’T smoke
  • DON’T Go on a low-fat diets – because you are at risk of malnourishment.

Do this:

  • DO eat six small meals per day, instead of the traditional three. A big meal might not be appealing if you have digestion troubles from PEI.
  • DO take vitamins. You may need to take vitamins A, D, E, and K to replace ones that aren’t getting absorbed from your diet.
  • DO talk with your family and friends to get the support you need while you’re getting treatment.

What is pancreatic exocrine insufficiency (PEI)

Pancreatic Exocrine Insufficiency (PEI) is a condition that causes problems in how you digest food. Your pancreas doesn't make enough of the enzymes that your body needs to break down and absorb nutrients.

Enzymes speed up chemical reactions in the body. The enzymes made by the pancreas move into the small intestine, where they help break down the food that you have eaten.

When you have PEI, you don't get the nutrition you need because your body can't absorb fats and some vitamins and minerals from foods.

There are drugs that work for this condition that give you much needed supply of enzymes. Besides taking medicine, you can manage your symptoms by making sure you follow the right diet. Your doctor will recommend foods that will help you get enough nutrients and protein that you might be missing.

Signs & Symptoms of pancreatic exocrine insufficiency (PEI)

You may not have any symptoms at first. But once your pancreas gets so damaged that it starts to negatively affect your ability to absorb fats, you may experience the following:

  1. Pain or tenderness in your belly
  2. Foul-smelling bowel movements
  3. Diarrhea
  4. Gas and bloating
  5. Feeling full

You might also lose weight among other things, because your body doesn’t absorb enough vitamins. For instance, you could develop a bleeding disorder if you're not getting enough vitamin K. Or you could get bone pain if you don't get enough vitamin D.

Risk Factors of pancreatic exocrine insufficiency (PEI)

Your doctor will investigate a diagnosis of PEI If you have a new diagnosis of pancreatic disease or a new diagnosis of a condition that may predispose to PEI or malabsorption, including:

  • Chronic Pancreatitis (CP)
  • Type 1 Diabetes
  • Unresponsive celiac disease
  • HIV/AIDS
  • If you are current or former smokers
  • Longstanding history of alcohol abuse (defined as >5 drinks/day)
  • The last two risk categories interact, such that risk of PEI with alcohol abuse is heightened among current smokers

PEI will be investigated if you have any of the unexplained suggestive symptoms, even in the absence of the conditions just mentioned.

PEI is occasionally confused with some other GI conditions, such as peptic ulcers, Crohn’s and IBS, since they have many of the same symptoms. If you’re showing some of these symptoms, it is important to speak to your doctor to determine whether you have PEI or another GI condition.

Treating pancreatic exocrine insufficiency (PEI)

  • PERTs: Apart from a healthy diet, the main treatment for PEI is pancreatic enzyme replacement therapy (PERT). You take prescription pills that replace the enzymes your pancreas isn't making. These enzymes break down your food so you can more easily digest and absorb it. You must take them during or immediately after your meals. If you take them before you eat, the replacement enzymes may move through your stomach before your food gets there.
  • Antacid: You may also need to take an antacid – called a proton-pump-inhibitor – to keep your stomach from breaking down pancreatic enzymes before they can start to work. This is only needed for certain types of PERT; check with your pharmacist if you are unsure. Together with your doctor, you should be able to come up with a treatment plan that works for you, so you can get back to living your life, your way!

Managing pancreatic exocrine insufficiency (PEI)

The right diet is very important for managing PEI. Your doctor and/or dietician can help you choose the foods that keep your energy level up and give you the nutrition you need. Here are a few tips:Don’t do this:

  • DON'T drink alcohol: It can make it even harder for your body to absorb fat, and can damage your pancreas over time.
  • DON'T smoke
  • DON'T Go on a low-fat diets – because you are at risk of malnourishment.

Do this:

  • DO eat six small meals per day, instead of the traditional three. A big meal might not be appealing if you have digestion troubles from PEI.
  • DO take vitamins. You may need to take vitamins A, D, E, and K to replace ones that aren't getting absorbed from your diet.
  • DO talk with your family and friends to get the support you need while you're getting treatment.

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