The pancreas has both endocrine and exocrine functions. The endocrine pancreas produces hormones such as insulin and glucagon. The exocrine pancreas produces digestive enzymes, including lipase, protease, and amylase. Pancrelipase products contain these enzyme classes and are used to treat EPI caused by conditions such as cystic fibrosis, chronic pancreatitis, pancreatectomy, or other pancreatic conditions. (DailyMed) EPI occurs when enzyme delivery to the small intestine is inadequate. Fat maldigestion is often the most clinically visible feature because inadequate lipase activity produces steatorrhea: bulky, oily, greasy, foul-smelling stool that may float. Protein and carbohydrate digestion may also be impaired, contributing to bloating, gas, weight loss, sarcopenia, poor wound healing, fatigue, and global nutritional decline. EPI can lead to malabsorption and malnutrition. NIDDK notes that EPI can impair digestion and may require small frequent meals and PERT with eating; it also identifies complications such as malnutrition, low levels of fat-soluble vitamins A, D, E, and K, and low bone mass. (NIDDK) NP clinical reasoning point: Steatorrhea is not a diagnosis by itself. It is a clue. The NP must determine whether the...