Exocrine Pancreatic Insufficiency Management and Assessment
Summary
Exocrine pancreatic insufficiency (EPI) arises from inadequate secretion of digestive enzymes due to pancreatic acinar cell loss or ductal obstruction. It manifests as maldigestion, steatorrhoea, weight loss and micronutrient deficiencies. Diagnosis relies on a combination of clinical evaluation, indirect tests such as faecal elastase measurement, breath tests and imaging studies of the pancreas. Management centres on pancreatic enzyme replacement therapy (PERT), with individualised dosing guided by symptom resolution and measurement of nutritional markers. Enteric-coated formulations and acid suppression may enhance enzyme delivery to the duodenum, while dietary modification and supplementation of fat-soluble vitamins and micronutrients address residual malabsorption. Recent advances have explored optimising PERT formulations, improving diagnostic sensitivity and integrating multidisciplinary care pathways. Adherence to therapy and patient education on dose adjustment according to meal fat content remain critical. EPI occurs in diverse contexts including chronic pancreatitis, pancreatic malignancy, post-surgical states and in certain diabetics, underscoring its global burden. Long-term follow-up emphasises monitoring of body composition, bone health and fat-soluble vitamin status to mitigate complications. Emerging research seeks to refine non-invasive diagnostic assays and novel enzyme delivery systems, with the aim of enhancing symptom control, nutritional outcomes and quality of life.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Exocrine Pancreatic Insufficiency Management and Assessment publication trend
The graph below shows the total number of articles in exocrine pancreatic insufficiency management and assessment across all publications each year (not limited to Nature Index journals).
Technical terms
Coefficient of fat absorption: The percentage of dietary fat absorbed, used to assess efficacy of enzyme therapy.
Enteric coating: A pH-sensitive polymer layer applied to enzyme capsules to protect them from gastric acid.
Faecal elastase: An indirect stool test measuring pancreatic elastase concentration as a marker of exocrine function.
Steatorrhoea: Excess fat in faeces leading to bulky, oily stools, characteristic of malabsorption.
References
- Comparative Investigation of pH–Dependent Availability of Pancreatic Enzyme Preparations In Vitro. Pharmaceuticals (2024).
- Efficacy of pancreatic enzyme replacement therapy in chronic pancreatitis: systematic review and meta-analysis. Gut (2016).
- Do Patients Benefit from Micronutrient Supplementation following Pancreatico-Duodenectomy?. Nutrients (2023).
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.