Table 4.

Etiologies of exocrine pancreatic insufficiency

Mechanism	Etiology
Decreased lipase production and delivery, increase lipase destruction	Chronic pancreatitis, cystic fibrosis, diabetes
Pancreatic duct obstruction	Periampullary tumor, pancreatic head cancer, IPMN, benign tumors
Decreased endogenous lipase stimulation and production	Celiac disease, Crohn’s disease, Shwachman–Diamond syndrome
Motility disorders (decrease contact time, interaction with chyme, decrease stimulation of pancreatic enzymes)	Gastrectomy, gastric bypass, extensive small bowel resection

Abbreviation: IPMN, intraductal papillary mucinous neoplasm.