Could it be PEI?

We all experience unwanted digestive symptoms now and again, but when you have PEI these symptoms are on-going and can disrupt day-to-day activities.

PEI is not always easy to spot - this is because the symptoms of PEI are experienced by lots of people with other conditions like irritable bowel syndrome.

If left untreated PEI can lead to other nutrition-related health problems as you are not absorbing enough nutrients and energy from your food.¹

Signs and Symptoms

The signs and symptoms of PEI vary from person to person – and you don’t have to experience all of the following symptoms to have PEI.

Common PEI symptoms include: ^1-3

Diarrhoea — loose, watery stools which are passed more often than usual and caused by food moving too quickly through your digestive system.
Wind (flatulence), bloating and stomach pain — linked to the build-up of gases from undigested food.
Frothy, oily, smelly stools (steatorrhoea) that may be difficult to flush away — caused when undigested dietary fats pass through your system and into your stools.
Weight loss — due to too few calories or other nutrients being available from your food.

If you have one or more of these symptoms, you should talk to your doctor about whether it could be PEI. These symptoms may also be related to other medical conditions and should be discussed with your doctor.

Related health conditions

PEI does not occur in isolation – it’s linked to pancreatic damage caused by other health conditions or medical procedures¹

PEI is most commonly seen in people who have: ^4-6

Chronic pancreatitis – where long-term inflammation can stop the pancreas from functioning properly.
Cystic fibrosis – this inherited condition can affect different parts of the body, including the pancreas, and PEI can be a problem from birth.

Other conditions and procedures that are also associated with PEI: ¹

Acute pancreatitis (inflammation of the pancreas where symptoms starts abruptly).
Certain types of gastric surgery.
Surgical removal of all or part of your pancreas (a pancreatectomy).
Pancreatic cancer.
Diabetes.
Inflammatory bowel disease (IBD).

Spotting PEI

PEI symptoms can often be confused with those caused by other gastrointestinal problems – which makes PEI difficult to spot and it may go undetected and untreated.¹

If you think it could be PEI talk to your doctor.

It’s important to tell your doctor about all your symptoms as well as any other health issues and treatment you have had or are currently undergoing.

You can make a list of things to discuss with you doctor that could include:

Any diagnosed conditions or medical procedures you have had.
All the different symptoms you are experiencing – along with how severe they are, when they started and when they usually occur.
How often you have to go to the toilet and what your stools look like .

Whether you have lost weight unexpectedly or are having problems maintaining your weight – even if you are eating a healthy diet.
Any medications you are currently taking – including any products from health stores or supermarkets.
Any particular type of food which you find aggravates any of your symptoms (e.g. fatty foods).

Talking to you doctor

To get the most out of your appointment try writing a list – some of the important things to remember include:

Timing and severity of your symptoms.
Your medical history including any surgery you’ve had.
All the medications and supplements you’re taking.
Any questions or concerns you have.

Check your symptoms

You may not always be comfortables taling about your symptoms - but it can be the key to making the right diagnosis.

Let your doctor know if you have any of these symptoms – it could be PEI:¹

Diarrhoea
Wind
Bloating

Stomach pain*
Smelly, oily stools
Unexpected weight loss

*Stomach pain, also known as tummy or abdominal pain, is pain that you feel anywhere from just under your ribs to your pelvis. It can also be called stomach ache or cramp.

PEI shares the same symptoms as other gastrointestinal diseases such as irritable bowel syndrome (IBS), coeliac disease, Crohn’s disease, ulcerative colitis and certain bacterial gut infections.¹

If left untreated PEI can lead to additional nutrition-related problems such as tiredness, weak bones and vitamin deficiencies.

For more information about PEI (pancreatic exocrine insufficiency), or if you have any questions relating to symptoms or treatment options, please speak to a healthcare professional.

Smith RC, et al. Australasian guidelines for the management of pancreatic exocrine insufficiency. Australasian Pancreatic Club, October 2015.
Arasaradnam RP, et al. Gut 2018;67:1380–1399.
Struyvenberg MR, et al. BMC Medicine 2017;15:29.
Keller J, Layer P. Gut. 2005;54(Suppl 6):vi1-28.
Gibson-Corley KN, et al. J Pathol 2016; 238(2): 311–320.
Cystic Fibrosis Nutrition Guideline Authorship Group (2017). Nutrition Guidelines for Cystic Fibrosis in Australia and New Zealand, ed. Scott C. Bell, Thoracic Society of Australia and New Zealand, Sydney. Available at: https://www.thoracic.org.au/documents/item/1045 (accessed 12/4/19).