EPI has a range of causes, some of which are autoimmune conditions. Treating these underlying conditions can help resolve symptoms of EPI and reduce your risk of complications.

Exocrine pancreatic insufficiency (EPI) happens when your pancreas doesn’t have enough digestive enzymes, making it hard for your body to extract nutrients from food.

This can lead to symptoms such as digestive difficulties, pain, and fatigue.

Multiple underlying concerns can lead to EPI, including autoimmune conditions like autoimmune pancreatitis and celiac disease. However, EPI itself isn’t an autoimmune disease.

Read on to learn more about the link between EPI and autoimmunity.

EPI is often the result of conditions that damage the pancreas. Conditions such as pancreatic cancer and chronic pancreatitis can cause this.

But for some people, EPI links to autoimmunity.

For instance, it can happen as a complication of autoimmune pancreatitis, a chronic condition that occurs when your immune system attacks your pancreas. Not everyone with autoimmune pancreatitis will develop EPI, though.

There are two subtypes of autoimmune pancreatitis: type 1 and type 2. Type 1 typically affects organs beyond the pancreas including the liver, bile ducts, kidneys, lymph nodes, and salivary glands. Conversely, type 2 stays within the pancreas.

EPI also sometimes links to celiac disease, an autoimmune condition where your body attacks its tissues when you eat gluten. It can cause chronic inflammation in the small intestine as well as symptoms like diarrhea, bloating, and stomach pain.

The cause of EPI always links to the underlying condition that leads it to develop.

There isn’t a known cause for autoimmune pancreatitis.

As is true for all autoimmune conditions, it happens when the immune system “malfunctions” and damages healthy body tissue. However, researchers don’t know what causes this immune system reaction or why it leads to EPI for some people.

Celiac disease can cause EPI because the condition can affect the pancreas. It’s thought that celiac disease impairs the release of digestive hormones secretin and cholecystokinin (CCK), making it harder for your body to digest food.

As is true for the cause of EPI, the risk factors depend on the underlying cause.

Autoimmune causes

For instance, the risk factors for type one autoimmune pancreatitis include being male and older than 60. However, these same risk factors don’t apply to type 2. People often receive a type 2 diagnosis in their 40s or 50s, and gender doesn’t affect risk.

Celiac disease has multiple risk factors. These include:

Nonautoimmune causes

EPI is also linked to underlying factors. These factors aren’t autoimmune, but they can increase your risk of EPI because they can damage your pancreas.

They include:

You can often manage EPI by treating the underlying cause.

For autoimmune pancreatitis, steroids are a commonly used first-line treatment that can reduce inflammation. Your doctor might also recommend immunosuppressants.

The primary treatment for celiac disease is a gluten-free diet. Over time, this can allow the small intestine and the pancreas to heal. Some people also take supplements to correct nutrient deficiencies and steroids to reduce inflammation.

No matter what factors have led to your EPI, treatment might involve taking vitamins and supplements. This can help replace the nutrients your body isn’t absorbing. Also, doctors often prescribe pancreatic enzyme replacements to help you extract nutrients from the food you eat.

Long-term management depends on the individual and on the factors that led to the development of EPI. Treatment can reduce your symptoms and improve your quality of life.

Multiple underlying factors, including autoimmune conditions such as autoimmune pancreatitis and celiac disease, can cause EPI. However, EPI itself is not an autoimmune condition.

Treating these underlying conditions can help manage the symptoms of EPI. Additional EPI treatments, such as pancreatic enzyme supplements, can provide additional relief.