Exocrine pancreatic insufficiency (EIP) may be caused by a number of conditions. These all result in insufficient pancreatic digestive enzymes being released into the intestinal tract, resulting in a malabsorption syndrome.
Common conditions associated with EIP include:
(1) chronic pancreatitis (due to alcohol, autoimmune, drugs, gallstones, etc)
(2) cystic fibrosis
(3) pancreatic tumor
(4) status post pancreatic surgery, especially resections
(5) peripancreatic tumor obstructing the main pancreatic duct
Less common conditions associated with EIP include:
(1) hemochromatosis
(2) HIV infection
(3) graft versus host disease (GvHD)
(4) advanced age
(5) Shwachman-Diamond syndrome
(6) therapy with a checkpoint inhibitor
(7) therapy with somatostatin analog
(8) pancreatic hypoplasia or agenesis
(9) Pearson syndrome
(10) Johanson Blizzard syndrome
(11) Shteyer syndrome
(12) nonalcoholic fatty pancreas disease
(13) Zollinger-Ellison syndrome
(14) congenital isolated pancreatic enzyme deficiency
Conditions that may be associated with EIP:
(1) diabetes mellitus
(2) inflammatory bowel disease (? autoimmune pancreatitis)
(3) gastrointestinal surgery
(4) celiac disease
(5) current tobacco use (? alcohol use or other cause)