Diagnosing EPI and Managing With The Appropriate PERT Dosing

Thank you AbbVie for your support on this podcast episode.

In this episode, Carol Antequera, DMSc, PA-C, and Jennifer Geremia, PA-C, dive into the clinical nuances of diagnosing and managing exocrine pancreatic insufficiency (EPI). Guided by AGA best practices, they explore how to recognize hallmark symptoms such as chronic diarrhea, steatorrhea, weight loss, and fatigue, even in patients without overt pancreatic disease. From identifying key risk factors—including chronic pancreatitis, cystic fibrosis, pancreatic cancer, diabetes, and post-surgical anatomy—to the appropriate use of diagnostic tools like fecal elastase testing, this conversation provides a clear roadmap for providers managing suspected EPI in both tertiary and community care settings. The discussion emphasizes practical guidance for initiating pancreatic enzyme replacement therapy (PERT), determining optimal dosing, addressing challenges with adherence, and monitoring nutritional deficiencies and vitamin absorption. Carol and Jennifer also highlight the importance of dietary counseling, managing psychosocial factors, and the long-term safety of empiric therapy, even when diagnostic certainty is limited. Whether you're new to managing EPI or seeking tips for improving outcomes in complex cases, this episode offers actionable, evidence-based strategies to enhance your GI practice.

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