Conditions Associated With EPI

EPI may be associated with other conditions

EPI can occur in people with certain diseases and conditions that affect the pancreas. These diseases may be present when you’re born or develop over time.2,3

Conditions that may be associated with EPI include2-13:

Cystic fibrosis (CF)

CF is an inherited genetic disorder that mainly affects the lungs, digestive, and reproductive systems. People with CF produce thick, sticky mucus. When the pancreas is clogged with mucus, it can’t properly release the digestive enzymes needed to properly break down food.

Chronic pancreatitis (CP)

CP is a disease in which there is inflammation of the pancreas that lasts a long time. This is the most common cause of EPI in adults. CP may cause irreversible damage to the pancreas, including the cells that make digestive enzymes.

Surgical removal of the pancreas (pancreatectomy)

Surgery involving the pancreas may affect its production of digestive enzymes. This, in turn, may lead to EPI. Removing part or all of the pancreas may be done as part of a treatment for pancreatic cancer, pre-cancerous pancreatic tumors, or chronic pancreatitis. It might also be done in cases where the pancreas has been severely damaged due to an injury.

Pancreatic cancer

In patients with pancreatic cancer, blockage of the pancreatic duct is common. Treatment may involve surgically removing part or all of the pancreas, resulting in EPI.

Gastrointestinal surgery

The digestive enzymes produced by the pancreas may be affected by certain types of abdominal surgeries, especially surgeries that involve the stomach and intestines.

Diabetes (type I and type IIIC)

The pancreas produces digestive enzymes and also produces insulin, a hormone that helps control blood sugar levels. People with diabetes have trouble producing or using insulin. Some people with diabetes (type I and IIIC) may also have EPI.

If you have one of these medical conditions, as well as any of the symptoms of EPI, make sure you let your doctor know.

Get Information About
How EPI Is Diagnosed
What is EPI?

What is EPI?

Find Out More
Your medical history and tests can help determine if you have EPI

Your medical history and tests can help determine if you have EPI

See How
Hear from other people who have EPI

Hear from other people who have EPI

Watch Videos

Uses and Important Safety Information


CREON is a prescription medicine used to treat people who cannot digest food normally because their pancreas does not make enough enzymes due to cystic fibrosis, swelling of the pancreas that lasts a long time (chronic pancreatitis), removal of some or all of the pancreas (pancreatectomy), or other conditions.

Important Safety Information

  • CREON may increase your chance of having a rare bowel disorder called fibrosing colonopathy. The risk of having this condition may be reduced by following the dosing instructions that your doctor gave you.
  • Do not crush or chew CREON capsules or its contents, and do not hold the capsule or capsule contents in your mouth. Crushing, chewing, or holding the CREON capsules in your mouth may cause irritation in your mouth. Talk to your doctor or consult the CREON Medication Guide for how to take CREON if you have trouble swallowing capsules. Always take CREON with a meal or snack and enough liquid to swallow CREON completely. Take CREON exactly as your doctor tells you.
  • Tell your doctor right away if you have unusual or severe: stomach (abdominal) pain, bloating, trouble passing stool, nausea, vomiting, diarrhea, worsening of painful, swollen joints (gout), or allergic reactions including trouble with breathing, skin rashes, or swollen lips.
  • The most common side effects include: increased (hyperglycemia) or decreased (hypoglycemia) blood sugars, pain in your stomach area (abdominal area), frequent or abnormal bowel movements, gas, vomiting, dizziness, or sore throat and cough.
  • CREON and other pancreatic enzyme products are made from the pancreas of pigs, the same pigs people eat as pork. These pigs may carry viruses. Although it has never been reported, it may be possible for a person to get a viral infection from taking pancreatic enzyme products that come from pigs.

Refer to the CREON Medication Guide and Full Prescribing Information every time you refill your prescription because information may change. Tell your healthcare provider if you have any symptom or side effect that bothers you or that does not go away.

You are encouraged to report negative adverse effects of prescription drugs to the FDA. Visit or call 1-800-FDA-1088.

If you cannot afford your medication, contact

Reference: 1. CREON [package insert]. North Chicago, IL: AbbVie Inc.

  1. References:
  2. CREON [package insert]. North Chicago, IL: AbbVie Inc.
  3. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122.
  4. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003;26(suppl 1):S5-S20.
  5. About cystic fibrosis. Cystic Fibrosis Foundation website.​/What-is-CF​/About-Cystic-Fibrosis/. Accessed October 20, 2017.
  6. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73.
  7. About chronic pancreatitis. The National Pancreas Foundation website.​/patient-information​/chronic-pancreatitis/. Accessed October 20, 2017.
  8. Keller J, Layer P. Human pancreatic exocrine response to nutrients in health and disease. Gut. 2005;54(suppl 6):vi1-vi28.
  9. Surgery for pancreatic cancer. American Cancer Society website.​/content/cancer/en/cancer/pancreatic-cancer/treating/surgery/. Accessed October 20, 2017.
  10. Hardt PD, Hauenschild A, Jaeger C, Teichmann J, Bretzel RG, Kloer HU. High prevalence of steatorrhea in 101 diabetic patients likely to suffer from exocrine pancreatic insufficiency according to low fecal elastase 1 concentrations: a prospective multicenter study. Dig Dis Sci. 2003;48(9):1688-1692.
  11. Cavalot F, Bonomo K, Fiora E, et al. Does pancreatic elastase-1 in stools predict steatorrhea in type 1 diabetes? Diabetes Care. 2006;29(3):719-721.
  12. Hahn JU, Kerner W, Maisonneuve P, Lowenfels AB, Lankisch PG. Low fecal elastase 1 levels do not indicate exocrine pancreatic insufficiency in type-1 diabetes mellitus. Pancreas. 2008;36(3):274-278.
  13. Bures J, Cyrany J, Kohoutova D, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16(24):2‌978-‌2990.
  14. Czakó L, Hegyi P, Rakonczay Z, Wittmann T, Otsuki M. Interactions between the endocrine and exocrine pancreas and their clinical relevance. Pancreatology. 2009;9(4):351-359.

back to top Back to Top Arrow