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Diagnosis of Exocrine Pancreatic Insufficiency

  • Pancreas (T Stevens, Section Editor)
  • Published:
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Opinion statement

The accurate diagnosis of exocrine pancreatic insufficiency (EPI) helps identify those in need of pancreatic enzyme replacement therapy. Conversely, ruling out EPI identifies those in which additional evaluation should be pursued to explain their symptoms. There are many available tests that can be used to diagnose EPI; however, the tests must be tailored to each clinical scenario. Tests that are convenient but less accurate (e.g., fecal elastase-1, qualitative fecal fat determination) are best suited for patients with a high pretest probability of EPI. In contrast, tests that are highly accurate but more cumbersome (e.g., endoscopic pancreatic function testing, 72-h fecal fat collection) are favored in patients suspected to have mild EPI or an early stage of chronic pancreatitis. Additional research is needed to identify a more convenient means of accurately diagnosing at all stages of EPI.

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Abbreviations

CFA:

Coefficient of fat absorption

EPI:

Exocrine pancreatic insufficiency

FE-1:

Fecal elastase-1

MTBT:

13C-mixed triglyceride breath test

PERT:

Pancreatic enzyme replacement therapy

PPI:

Proton pump inhibitor

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Conflict of Interest

Phil A. Hart declares that he has no conflict of interest.

Darwin L. Conwell declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Section of Pancreatic Disorders, Division of Gastroenterology, Hepatology, & Nutrition, The Ohio State University Wexner Medical Center, 410 West Tenth Avenue, Columbus, OH, 43210, USA

    Phil A. Hart MD & Darwin L. Conwell MD, MS

Authors
  1. Phil A. Hart MD
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  2. Darwin L. Conwell MD, MS
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Correspondence to Phil A. Hart MD or Darwin L. Conwell MD, MS.

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Hart, P.A., Conwell, D.L. Diagnosis of Exocrine Pancreatic Insufficiency. Curr Treat Options Gastro 13, 347–353 (2015). https://doi.org/10.1007/s11938-015-0057-8

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