Table:

Some of the causes of exocrine pancreatic insufficiency

Etiology	Frequency of EPI	Comments
Chronic pancreatitis	Dependent on etiology and duration of disease. Occurs in 30–50%	Usually requires loss of 90% of exocrine enzyme secretion. Most common in chronic pancreatitis due to genetic causes, alcohol, autoimmune, or smoking.
Cystic fibrosis	Nearly universal, from birth
Pancreatic cancer	50–90%, depending on location	Most frequent with cancer of head of pancreas, with pancreatic ductal obstruction.
Pancreatic resection	Variable depending on operation	Most common with larger resections, most common after Whipple resection
Asynchrony after GI surgery	Roux-en-Y surgeries most common, including gastric bypass	While pancreatic enzyme secretion may be normal, inadequate mixing with food can cause maldigestion
Shwachman-Diamond and Johanson-Blizzard	EPI very common, but diseases are rare	Genetic syndromes usually detected in childhood
Acute pancreatitis	More common with more extensive necrosis and those	Can occur even in absence of necrosis, and may persist
	with alcohol or smoking as etiologies
Diabetes	Reduced fecal elastase common, but EPI rare	Longstanding diabetes may produce pancreatic damage similar to chronic pancreatitis, termed “diabetic pancreatopathy”
Zollinger-lollinger-Ellison syndrome	EPI common, but condition quite rare	Acid denaturation of pancreatic enzymes