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Is It Exocrine Pancreatic Insufficiency or IBS?

There are many signs, symptoms, and conditions that can mimic irritable bowel syndrome. I believe it is important to be knowledgeable in order to help us feel better! After all, we are the ones who know our bodies the best. We are all looking for “cures” and answers, and this could be one of them.

What is exocrine pancreatic insufficiency?

A condition called exocrine pancreatic insufficiency causes problems with food digestion. When this condition is present, the pancreas doesn’t make enough enzymes in our small intestines that are required to break down and absorb nutrients. Enzymes are important because they speed up chemical reactions in our bodies. When there is a shortage of enzymes, a person with exocrine pancreatic insufficiency is unable to get the nutrition they need because the body doesn’t absorb proper amounts of fats, vitamins, and minerals from food. This can cause one to have belly pain and lose weight.

The most common causes of exocrine pancreatic insufficiency are chronic pancreatitis, having surgery on your pancreas, stomach, or intestines, Cystic fibrosis, Crohn’s disease, and celiac disease. The good news is, there are treatments called pancreatic enzyme replacement therapies that work for most people. They give sufficient supply of enzymes so food is able to correctly digest. Other than taking medicine, exocrine pancreatic insufficiency can be managed by making sure the right diet is followed, including adding more vitamins and minerals and eating more healthy fats. Of course, it is always important to consult your physician or a dietitian before beginning a new diet.1

How does exocrine pancreatic insufficiency relate to IBS?

One might ask, “what can be done to check for exocrine pancreatic insufficiency?” You can ask your doctor to run a blood test to check for certain vitamin and mineral deficiencies. Celiac disease labs can also be requested, as it is a known cause of exocrine pancreatic insufficiency. There are also 3-day fecal tests that can be done. Exocrine pancreatic insufficiency may not cause any symptoms at first, but once the pancreas becomes too damaged, it starts to affect the body’s ability to absorb fat. Because of this, one may get symptoms similar to IBS such as pain or belly tenderness, foul-smelling bowel movements, gas, diarrhea, and bloating.2

I can definitely see why someone would assume this is just IBS! It is also possible to live with both of these conditions. In fact, exocrine pancreatic insufficiency has been detected in patients in a study who met the criteria for IBS-D. It is thought that pancreatic enzyme therapy might reduce diarrhea and abdominal pain.3

Listen to your gut, and be persistent in finding a cause!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The IrritableBowelSyndrome.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Exocrine Pancreatic Insufficiency. The National Pancreatic Foundation. Available: https://pancreasfoundation.org/patient-information/ailments-pancreas/exocrine-pancreatic-insufficiency-epi/. Accessed: 1/7/20.
  2. James Toouli, Andrew V. Biankin, Mark R. Oliver, Callum B. Pearce, Jeremy S. Wilson, and Nicholas H. Wray. Management of pancreatic exocrine insufficiency: Australasian Pancreatic Club recommendations. Med J Aust 2010; 193 (8): 461-467. Published online October 18, 2010. Available: https://www.mja.com.au/journal/2010/193/8/management-pancreatic-exocrine-insufficiency-australasian-pancreatic-club#0_i1096061. Accessed: 1/7/20.
  3. Leeds JS1, Hopper AD, Sidhu R, Simmonette A, Azadbakht N, Hoggard N, Morley S, Sanders DS. Some patients with irritable bowel syndrome may have exocrine pancreatic insufficiency. Clin Gastroenterol Hepatol. 2010 May;8(5):433-8. Published online: 10/14/19. Available: https://www.ncbi.nlm.nih.gov/pubmed/19835990. Accessed: 1/7/20.

Comments

  • patk
    3 weeks ago

    This article describes my journey. After ten years of being diagnosed with IBS that just got continually worse — to a serious crisis flare this summer — I was recently diagnosed with EPI (through fecal and blood tests, and a colonoscopy). I now take over-the-counter enzymes with every meal and follow some dietary guidelines — avoid fats, wheat, and high fiber. I have been healthy for several months now, except for a couple of minor flares when I overindulged in some foods I shouldn’t have tried. “Listen to your gut, and be persistent in finding a cause!” Great advice.

  • tmholland moderator
    3 weeks ago

    @patk,

    I’m so glad you found some relief after such a tough time. I think your persistence and refusal to give up was a good part of this. That’s’ admirable. I think the advice offered is excellent as well. Thank you for sharing and I hope you are well today. -Todd, IrritableBowelSyndrome.net Team

  • Elizabeth Alvarez moderator
    3 weeks ago

    Very interesting article. I have never heard of this before. Thanks for sharing!

    Elizabeth (team member)

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