Pancreatic Exocrine Insufficiency (PEI)

What PEI is, why it happens, and how enzyme therapy and dietetic support can help you absorb nutrients properly again.

6 min read
Man holding his stomach due to digestive discomfort from PEI
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What Causes PEI? Symptoms to Watch For How a Dietitian Can Help
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PEI is a condition where the pancreas fails to produce enough digestive enzymes, resulting in poor digestion and nutrient absorption. It can lead to digestive symptoms, malnutrition and related health issues.

What Causes PEI?

PEI occurs when the pancreas doesn't produce enough enzymes — amylase, lipase and protease — to break down carbohydrates, fats and proteins. Without them, the body struggles to absorb nutrients.

The most common cause is chronic pancreatitis. Others include cystic fibrosis, pancreatic cancer, pancreatic surgery, and treatment for neuroendocrine tumours.

Symptoms to Watch For

  • Frequent diarrhoea or loose stools
  • Abdominal pain and bloating
  • Unexplained weight loss or malnutrition
  • Steatorrhea (fatty, pale stools)
  • Nutrient deficiencies (vitamin D, B12)

How a Dietitian Can Help

Nutritional Assessment

Evaluating your intake and identifying deficiencies caused by PEI, to guide an individualised plan.

Enzyme Therapy Guidance

Support with the correct dosage and timing of pancreatic enzyme replacement therapy (PERT), and help contacting your GP about a prescription.

Diet Modification

A personalised plan built around your needs, preferences and other conditions — focused on absorption, symptoms and preventing malnutrition.

Education & Support

Practical guidance and reassurance as you learn to manage PEI day to day.

Working with a specialist dietitian helps you absorb nutrients properly, manage symptoms, and prevent malnutrition — rather than guessing alone.
Gina Giebner
Written & Reviewed by Gina Giebner
HCPC Registered Dietitian · Current NHS Oncology Dietitian

Gina specialises in gastrointestinal and oncology nutrition, helping people manage complex digestive conditions like PEI, SIBO and post-treatment bowel changes with evidence-based, personalised care. As a specialist cancer dietitian, she works with patients throughout the UK.

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