Table 1.
Prevalence of EPI in different clinical conditions
| EPI caused by pancreatic disorders | ||
|---|---|---|
| Disease | EPI prevalence | Factors associated with EPI occurrence |
| Chronic pancreatitis | 30%–90% | • Long disease duration • Alcoholic etiology • Extensive calcifications • Ductal obstruction |
| Acute pancreatitis | Mild pancreatitis: 15%–20% Severe pancreatitis: 30%–40% |
• Necrosis extent (>30%) • Alcoholic etiology |
| Autoimmune pancreatitis | 30%–60% | Extensive mass/calcification |
| Unresectable pancreatic cancer | 20%–60% | • Head localization • Large size • Ductal obstruction • Coexistent chronic pancreatitis |
| Pancreatic neoplasms after surgery | Pancreaticoduodenectomy: 80%–90% Distal pancreatectomy: 20%–50% |
• Whipple intervention* • Gastropancreatic anastomosis* |
| Benign pancreatic tumor (before surgery) | 30%–60% | • Head localization • Large size • Ductal obstruction • Coexistent chronic pancreatitis |
| Cystic fibrosis | 80%–90% | Classes I, II, III, VI CFTR mutations |
| Shwachman–Diamond syndrome | 80%–90% | - |
| EPI caused by extrapancreatic disorders | ||
| Type I diabetes | 30%–50% | • High insulin requirement • Poor glycemic control • Early diabetes onset |
| Type II diabetes | 20%–30% | • Insulin requirement • Poor glycemic control • Long diabetes duration |
| Inflammatory bowel disease | Ulcerative colitis: 10% Crohn’s disease: 4% |
• Disease reactivation (only for temporary EPI) • Long disease duration • Surgical patients |
| Celiac disease | 5%–80% | Untreated disease (no gluten-free diet) |
| Pediatric intestinal transplantation | 10% | |
| HIV syndrome | 10%–50% | Retroviral therapy |
| Gastrointestinal surgery | Total/subtotal gastrectomy: 40%–80% Esophagectomy: 16% |
• Extensive intestinal resection • Vagal denervation |
| Sjogren’s syndrome | 10%–30% | |
| Aging | 15%–30% | Age >80 years |
| Tobacco usage | 10%–20% | Alcohol usage |
| Somatostatin analogs therapy | 20% | |
Note:
*
Only for head tumor.
Abbreviation: EPI, exocrine pancreatic insufficiency; CFTR, cystic fibrosis transmembrane conductance regulator; AP, acute pancreatitis; AIP, autoimmune pancreatitis; CT, computed tomography; USP, United States Pharmacopeia; EUS, endoscopic ultrasonography.