Diagnosing Exocrine
Pancreatic Insufficiency (EPI)

EPI is largely a clinical diagnosis2

EPI symptoms are similar to those associated conditions

Look for symptoms and associated conditions

EPI should be suspected when patients present with one or more symptoms, especially if they have an associated condition2


Talk with your patients about EPI symptoms and how they’re affected by them

Get the details

Signs and symptoms of EPI are not always evident3

  • Patients may modify their diet to help address symptoms
  • It is important to look at a patient’s medical history

Since patients may be hesitant to share all of their GI symptoms, a detailed and open conversation may help you obtain a diagnosis

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Discussion Guide

EPI is largely a clinical diagnosis

Tests can help confirm a diagnosis of EPI

Direct measures of pancreatic function include:

  • Secretin-pancreozymin stimulation tests performed by gastroenterologists at specialized centers2

Indirect measures of pancreatic function include:

  • 72-hour fecal fat collection, the standard for indirect testing2
  • Qualitative fecal fat analysis by microscopic examination of random stool samples used for screening4
  • Fecal elastase concentration (FEC) to measure the concentration of pancreatic enzyme elastase5

An abnormal secretin test or fecal elastase <200 µg/g may confirm an EPI diagnosis2,5

How to Manage EPI
Understand the impact that EPI can have

Understand the impact that EPI can have

Learn More
Symptoms of EPI are not always evident. Learn to recognize the signs

Symptoms of EPI are not always evident

Recognize the Signs
Use the CREON® (pancrelipase) Treatment Tracker to help educate patients about their therapy

What should a treatment plan for EPI include?

Learn More

Indications and Important
Safety Information

Indications1

CREON® (pancrelipase) Delayed-Release Capsules is a pancrelipase which is a combination of porcine-derived lipases, proteases, and amylases indicated for the treatment of exocrine pancreatic insufficiency due to cystic fibrosis, chronic pancreatitis, pancreatectomy, or other conditions.

Important Safety Information

  • Fibrosing colonopathy is associated with high-dose use of pancreatic enzyme replacement in the treatment
    of cystic fibrosis patients. Exercise caution when doses of CREON exceed 2,500 lipase units/kg of body weight
    per meal (or greater than 10,000 lipase units/kg of body weight per day).
  • To avoid irritation of oral mucosa, care should be taken to ensure that CREON is not crushed, chewed, or retained in the mouth. CREON should always be taken with food.
  • Porcine-derived pancreatic enzyme products contain purines. Caution should be exercised when prescribing CREON to patients with gout, renal impairment, or hyperuricemia.
  • There is theoretical risk of viral transmission with all pancreatic enzyme products including CREON.
  • Exercise caution when administering pancrelipase to a patient with a known allergy to proteins of porcine origin.
  • Adverse reactions that occurred in at least 2 cystic fibrosis patients (greater than or equal to 4%) receiving CREON were vomiting, dizziness, and cough.
  • Adverse reactions that occurred in at least 1 chronic pancreatitis or pancreatectomy patient (greater than or equal to 4%) receiving CREON were hyperglycemia, hypoglycemia, abdominal pain, abnormal feces, flatulence, frequent bowel movements, and nasopharyngitis.
  • CREON is not interchangeable with any other pancrelipase product.

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

  1. References:
  2. CREON [package insert]. North Chicago, IL: AbbVie Inc.
  3. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73.
  4. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122.
  5. Hammer HF. Pancreatic exocrine insufficiency: diagnostic evaluation and replacement therapy with pancreatic enzymes. Dig Dis. 2010;28(2):339-343.
  6. Leeds JS, Oppong K, Sanders DS. The role of fecal elastase-1 in detecting exocrine pancreatic disease. Nat Rev Gastroenterol Hepatol. 2011;8(7):405-415.

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