EPI Glossary of Terms

The process by which nutrients from digested food pass through the intestinal wall into the bloodstream. In EPI, fat absorption is impaired due to lack of lipase enzymes.

A digestive enzyme produced by the pancreas and salivary glands that breaks down carbohydrates (starches) into simpler sugars. One of three main enzymes in PERT.

A rare form of chronic pancreatitis caused by the body's immune system attacking the pancreas. Can lead to EPI if left untreated.

A digestive fluid produced by the liver and stored in the gallbladder. Bile helps emulsify fats for easier digestion by lipase enzymes.

Uncomfortable feeling of fullness or swelling in the abdomen, often caused by gas. A common symptom of EPI due to incomplete digestion of food.

An autoimmune disorder where gluten causes damage to the small intestine. Can occur alongside EPI and cause similar malabsorption symptoms.

Long-term inflammation of the pancreas that causes permanent damage to the pancreatic tissue. The most common cause of EPI, accounting for 70-80% of cases.

A brand name prescription PERT medication containing pancreatic enzymes (lipase, protease, amylase). One of the most commonly prescribed enzyme supplements.

A genetic disorder affecting the lungs and digestive system. Approximately 85-90% of people with cystic fibrosis develop EPI due to thick mucus blocking pancreatic ducts.

A condition where the stomach takes longer than normal to empty its contents. Can affect PERT effectiveness and timing of enzyme administration.

Frequent, loose, or watery bowel movements. In EPI, diarrhea often occurs due to malabsorption of fats and other nutrients.

The first section of the small intestine where digestive enzymes from the pancreas mix with food. Key site for nutrient digestion and absorption.

The pancreas's role in producing hormones (like insulin) that regulate blood sugar. Distinct from exocrine function, though damage to the pancreas can affect both.

A protective layer on PERT capsules that prevents enzymes from being destroyed by stomach acid. Allows enzymes to be released in the small intestine where they work.

A protein that speeds up chemical reactions in the body. Digestive enzymes break down food into absorbable nutrients. The main pancreatic enzymes are lipase, protease, and amylase.

A condition where the pancreas does not produce enough digestive enzymes to properly break down food, leading to malabsorption of nutrients, particularly fats.

The pancreas's role in producing digestive enzymes that are released into the small intestine. EPI is a disorder of exocrine function.

Vitamins A, D, E, and K that require fat for absorption. People with EPI often develop deficiencies in these vitamins due to fat malabsorption.

A stool test that measures levels of elastase-1, an enzyme produced only by the pancreas. The most common test for diagnosing EPI. Levels below 200 μg/g suggest EPI.

A stool test that measures the amount of fat in the stool over 72 hours. High fecal fat levels indicate fat malabsorption, which may suggest EPI.

A rare but serious complication of very high-dose PERT, causing narrowing of the colon. Risk is minimized by not exceeding recommended enzyme doses.

Excessive gas in the digestive system, often released through passing gas. A common EPI symptom caused by fermentation of undigested food by gut bacteria.

A small organ that stores bile produced by the liver. Gallbladder disease can cause symptoms similar to EPI and sometimes occurs alongside it.

Delayed stomach emptying that can affect how PERT works. May require adjusting enzyme timing or adding medications to improve stomach motility.

A rare genetic condition causing recurrent pancreatitis episodes that often begin in childhood. Can lead to chronic pancreatitis and EPI.

A functional bowel disorder causing abdominal pain and altered bowel habits. Often confused with EPI, but IBS does not cause malabsorption or weight loss.

A hormone produced by the endocrine cells of the pancreas that regulates blood sugar. Pancreatic damage can affect both enzyme and insulin production.

The pancreatic enzyme that breaks down dietary fats into fatty acids and glycerol. The most critical enzyme for people with EPI; PERT dosing is based on lipase units.

The measurement used to quantify lipase enzyme activity in PERT. Dosing is typically 500-1000 units per gram of dietary fat or 25,000-75,000 units per meal.

The failure of the intestines to properly absorb nutrients from digested food. In EPI, malabsorption primarily affects fats and fat-soluble vitamins.

Incomplete breakdown of food due to lack of digestive enzymes. Distinct from malabsorption, which refers to poor nutrient uptake. EPI causes both.

A condition resulting from not getting enough nutrients. Common in untreated or undertreated EPI due to malabsorption of fats, proteins, and vitamins.

A type of fat that is absorbed more easily than regular fats because it doesn't require pancreatic enzymes for digestion. Sometimes recommended for people with severe EPI.

Tiny beads containing enzymes inside PERT capsules. The enteric-coated microspheres protect enzymes from stomach acid and ensure proper release in the intestine.

Lack of essential nutrients due to inadequate intake or absorption. In EPI, deficiencies commonly include fat-soluble vitamins (A, D, E, K), vitamin B12, and zinc.

Stools that appear greasy, leave an oily residue, or float. A characteristic sign of fat malabsorption in EPI. Also called steatorrhea.

A gland located behind the stomach that produces digestive enzymes (exocrine function) and hormones like insulin (endocrine function). Damage to the pancreas can cause EPI.

The tube that carries digestive enzymes from the pancreas to the duodenum. Blockage of this duct (by stones, tumors, or cysts) can cause or worsen EPI.

Tests that measure how well the pancreas produces digestive enzymes. Includes direct tests (secretin stimulation) and indirect tests (fecal elastase, fecal fat).

Inflammation of the pancreas. Acute pancreatitis is a sudden episode; chronic pancreatitis involves ongoing damage. Chronic pancreatitis is the leading cause of EPI.

A brand name prescription PERT medication. Like other PERT products, it contains lipase, protease, and amylase enzymes in enteric-coated microspheres.

The primary treatment for EPI, consisting of prescription capsules containing digestive enzymes (lipase, protease, amylase) derived from porcine (pig) pancreas.

A brand name prescription PERT medication that also contains bicarbonate to help neutralize stomach acid, potentially improving enzyme effectiveness.

Medications that reduce stomach acid production (e.g., omeprazole, pantoprazole). Often prescribed with PERT to protect enzymes from acid degradation and improve effectiveness.

A digestive enzyme that breaks down proteins into amino acids. One of three main enzymes in PERT, important for protein absorption and nutrition.

EPI that develops as a result of another condition affecting the pancreas or digestive system (e.g., celiac disease, Crohn's disease, diabetes).

The part of the digestive tract between the stomach and large intestine where most nutrient absorption occurs. Pancreatic enzymes do their work here.

The medical term for fatty, oily, foul-smelling stools that float. The hallmark symptom of EPI, caused by undigested fat passing through the digestive system.

A brand name PERT medication that is NOT enteric-coated. Must be taken with a PPI. Sometimes prescribed when other PERT products are not effective.

Inadequate levels of essential vitamins in the body. In EPI, fat-soluble vitamin deficiencies (A, D, E, K) are most common due to impaired fat absorption.

Unintentional decrease in body weight, a common symptom of untreated or undertreated EPI. Occurs because nutrients, especially fats, are not properly absorbed.

A brand name prescription PERT medication. Contains lipase, protease, and amylase in enteric-coated beads within capsules for delayed release.