Exocrine pancreatic insufficiency

Reduced pancreatic digestive enzyme synthesis and secretion below the threshold needed for normal digestion. Presents with steatorrhea, weight loss and fat-soluble vitamin deficiency. Diagnosed by fecal elastase, breath tests and clinical features.

ICD-10 K86.81 drug

Also known as: EPI, Pancreatic exocrine insufficiency

Drugs used for this condition

APancreatinFirst line · Digestives. Multienzyme preparationsPancreatic enzyme replacement therapy (PERT) is the standard of care for exocrine pancreatic insufficiency. Evidence is based on RCTs and observational data in chronic pancreatitis, cystic fibrosis and post-pancreatectomy patients. Goals: control steatorrhea, restore nutritional status, normalize absorption of fat-soluble vitamins (A, D, E, K). Dose is titrated by lipase units per kilogram of body weight or per gram of dietary fat.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit