The pancreas is the main exocrine gland of the body. The pancreas does not produce enough enzymes needed for food digestion and the body cannot absorb the nutrients and vitamins that the body needs. It can cause diarrhea, vitamin deficiency and weight loss. Without proper treatment, it can lead to growth retardation, bone problems, shortened life span, and poor resistance in infants and children. What diseases can cause pancreatic exocrine insufficiency? 1, pancreatic parenchymal function decline or injury. Decline in pancreatic synthesis mainly includes chronic pancreatitis, acute pancreatitis, cystic fibrosis, pancreatic tumor, and post-pancreatic resection; 2, pancreatic duct obstruction. It mainly includes pancreatic tumor, pancreatic trauma; 3, imbalance of secretory feedback. It mainly includes Crohn’s disease, diabetes mellitus, post-gastrectomy, post-intestinal resection, Chorea syndrome, celiac disease, irritable bowel syndrome. The diagnosis of EPI may take some time because it shares symptoms with other diseases that affect the gastrointestinal tract. These include irritable bowel syndrome, peptic ulcer disease, gallbladder disease, and inflammatory bowel disease. What are the symptoms of pancreatic exocrine insufficiency? 1. The most common symptoms of EPI include diarrhea and weight loss. The diarrhea is called “steatorrhea” and the stool is watery, pale, large, foamy, greasy and extremely unpleasant tasting. The stool contains oil droplets because it is composed of undigested fat, and they stick to the toilet or float on the surface of the water, making it difficult to flush. Intestinal peristalsis is increased after eating fats and the stools are unformed, greasy, smelly and in large amounts; 2. weight loss; 3. fatigue; 4. cramps; 5. bloating; 6. pain in the stomach radiating to the back; 7. muscle weakness; 8. signs of vitamin deficiency such as brittle nails, hair loss, skin problems. What how to diagnose exocrine insufficiency of the pancreas? The pancreas has an extremely strong reserve capacity and compensatory mechanism. Early and mid-stage PEI can be without any clinical symptoms, and only in the late stage does fat digestion and malabsorption occur, with loss of body mass, leading to steatorrhea in severe cases, and other symptoms including abdominal pain and bloating. Pancreatic exocrine function can be measured by direct or indirect tests. 1, Direct test is to collect pancreatic fluid through ERCP pancreatic duct intubation or duodenal intubation with drugs or food to directly stimulate pancreatic secretion and understand its exocrine status. The direct test is the most sensitive and specific method to assess the exocrine function of the pancreas, but its routine clinical application is limited due to the high cost and invasive nature of the test. Indirect tests include stool test, breath test, urine test and blood test. 2, indirect test is relatively inexpensive, easy to operate, but the sensitivity and specificity is relatively insufficient, the most commonly used is fecal elastase-1 assay, but there are very few units to carry out in China. Therefore, it is generally judged mostly by the patient’s complaints, defecation and body mass reduction, etc. Once PEI is suspected, pancreatic enzyme replacement therapy (PERT) can be used, and the diagnosis of PEI can be further confirmed if the symptoms improve. Which how to treat and prevent pancreatic exocrine insufficiency? 1. pancreatic enzyme replacement therapy (PERT) is the standard treatment for EPI. pERT is a prescription medication derived from the pig pancreas and contains three pancreatic proteases. This therapy replaces the role of the pancreas. The amount of drug administered is based on the patient’s body weight, and the amount of fat eaten. It is important to emphasize that pancreatic enzyme preparations are more effective when taken with meals. It promotes protein absorption and relieves symptoms such as flatulence, diarrhea and abdominal pain. 2. Stop personal habits that affect pancreatic health and overall quality of life. A healthy lifestyle is important and includes: 1. stop smoking; 2. eat a balanced diet containing a normal amount of fat; 3. eat small, frequent meals; 4. stop drinking alcohol; 5. take vitamin supplements (mainly fat-soluble vitamins A, D, E, and K) as directed by a medical provider.