Pancreatic enzymes normally break down food as it passes through your small intestine, but without the necessary amount of those enzymes, your body can’t properly digest food. In addition to not being able to extract essential nutrients from your diet, you may also experience digestive symptoms such as fatty stools, abdominal pain, bloating, and diarrhea. Fortunately, such problems can be kept to a minimum with some easy-to-follow EPI management tips. The first step, though, is to determine if you have EPI.
Decoding Symptoms of EPI
EPI is relatively rare, and most GI symptoms are caused by other conditions. Still, there are some digestive problems that are associated with EPI, including:
Steatorrhea (fatty stools) Stools may have an oily appearance and be especially foul smelling. “The pancreatic enzymes help the body absorb fat and other nutrients,” says Frank G. Gress, MD, a gastroenterologist at the Icahn School of Medicine at Mount Sinai and The Mount Sinai Hospital in Oceanside, NY. “When there aren’t enough enzymes, the fat passes through the digestive system unabsorbed.”Bloating and gas Lack of proper digestion can also create gas that causes you to experience uncomfortable bloating, Dr. Gress says.Abdominal cramps The combination of gas and diarrhea means EPI can lead to very painful cramps.Weight loss and malnutrition Because the food you eat isn’t being properly digested, you can lose a lot of weight very quickly. You can also experience nutritional deficiencies, notably of vitamins A, D, E, and K, which are broken down with the help of the fats in the foods you eat; minerals such as magnesium and calcium; and essential fatty acids.
Managing the Digestive Problems of EPI
These are some proven, effective ways to lessen the symptoms of EPI. Take prescription enzyme supplements. First and foremost, if your doctor hasn’t brought it up, talk with him or her about a prescription for pancreatic enzyme replacement therapy (PERT). These supplements have proven to be very effective in helping people with EPI bring their bodies back into balance and resume proper digestion. PERT replenishes lost enzymes, according to Gress. As of 2010, pancreatic enzyme supplements are regulated by the Food and Drug Administration, which means they’re rigorously verified and contain precise amounts of pancreatic enzymes. Be sure to ask your doctor for a prescription and double-check the dosage. You can take supplements at the beginning of each meal or snack or space them out throughout your meal at your doctor’s recommendation. Tweak your diet. Next, try a few key diet modifications. Every person’s nutritional needs and sensitivities are different. You may find that greasy foods, spicy foods, or high-fiber foods such as beans and legumes cause digestive problems. Talk to your doctor or a registered dietitian about your specific diet needs to ensure you’re getting enough of the proper nutrients. It’s also a good idea to avoid fried and greasy foods. “That’s probably the most practical diet change to make,” Gress says. But keep in mind that healthy fats, especially monounsaturated and polyunsaturated fats, found in foods like nuts, seeds, avocados, and fish, are still an essential part of any diet. They can give you energy, support cell growth, and help you absorb those fat-soluble vitamins. Get relief from gas. If bloating is a problem for you, try over-the-counter gas remedies, suggests Gress. Eat small amounts of food, more often. “Having smaller meals where the food is digested with enzyme supplementation leads to improved absorption,” Gress says. Smaller meals may also help reduce bloating. Stay hydrated. Be sure to drink lots of water to avoid dehydration. This is especially important if you have diarrhea, Gress advises. Aim to drink eight 8-ounce glasses of fluids a day. Another tip: Try not to drink during meals, because it can interfere with digestion. Instead, wait about 20 to 30 minutes after eating, and then drink up! Boost nutrient intake with vitamin supplements. Talk to your medical team about whether you should take vitamin supplements, including A, D, E, and K, to make up for any deficiencies caused by EPI. If your doctor recommends vitamin supplements, take them at the same time as your pancreatic enzyme supplements. Exercise. You may find that staying active helps with digestive symptoms. Aim for 30 minutes of moderate activity — think: walking or riding a bike — every day. Stop smoking and limit alcohol. Research published in October 2019 in the journal Minerva Medica suggests that alcohol is involved in nearly half of all cases of EPI, while other studies have found that smoking is a risk factor for EPI. Since quitting is often easier said than done, talk to your healthcare provider about ways to kick the habit. Rely on your medical team. Because both digestive problems and nutritional deficiencies can be unique to you, work with your medical team to find a treatment plan that’s right for your needs. With your doctor and registered dietitian, you can find ways to ease the digestive problems that can occur with EPI. Additional reporting by Colleen de Bellefonds
