European Guidelines on the Diagnosis and Therapy of Pancreatic Exocrine Insufficiency (PEI)

UEG, EPC, EDS, ESPGHAN, ESPEN, ESDO, and ESPCG Evidence-Based Recommendations

Need for This Guideline

The need for this guideline is based on the wide variability in the diagnostic and therapeutic approach to pancreatic exocrine insufficiency in different clinical scenarios and different centers across Europe, as well as and in non-European countries.


Supporting Societies

The EPC has invited other UEG Specialist Member Societies to join this project with the aim of developing a transversal multidisciplinary guideline to be adopted by all specialties around Europe.

The following societies are participating in this project:

  • European Digestive Surgery (EDS)
  • European Society for Primary Care Gastroenterology (ESCPG)
  • European Society for Paediatric Gastroenterology, Hepatology and Nutrition  (ESPGHAN)
  • European Society for Clinical Nutrition and Metabolism (ESPEN)
  • European Society of Digestive Oncology (ESDO)
  • European Society of Primary Care Gastroenterology (ESPCG)

In addition, several UEG National Member Societies and Patient Associations have endorsed the proposal.


Steering Committee

The following EPC members constitute the steering committee responsible for the design of the guideline protocol and UEG application:

  • J. Enrique Domínguez-Muñoz (Spain, lead)
  • J. Matthias Löhr (Sweden, co-chair)
  • Daniel de la Iglesia-Garcia (Spain)
  • Miroslav Vujasinovic (Sweden)

Topics and Working Group Coordinators

  1. Concept, Pathogenesis, and Clinical Relevance (J. Enrique Dominguez-Munoz, Matthias Löhr)
  2. A General Diagnostic Approach to PEI (Gabriele Capurso, Pali Hungin)
  3. A General Therapeutic Approach to PEI (Peter Hegyi, Andrea Szentesi)
  4. PEI Secondary to Chronic Pancreatitis (Daniel de la Iglesia)
  5. PEI After Acute Pancreatitis (Vinciane Rebours, Johann Ockenga)
  6. PEI Associated with Pancreatic Cancer (Lukas Perhofer, Natalya Gubergrits)
  7. PEI Secondary to Cystic Fibrosis (Isabelle Scheers)
  8. PEI After Pancreatic Surgery (Roberto Salvia)
  9. PEI After Esophageal, Gastric, and Bariatric Surgery (Jonas Rosendahl)
  10. PEI in Patients with Type 1 and Type 2 Diabetes (Djuna Cahen)
  11. PEI in Other Conditions (Miroslav Vujasinovic)

Project Timelines for 2024

Milestone Deadline
1st draft of the manuscript January 31st
Manuscript submission March 31st
Official presentation Annual EPC Meeting 2024 (end of June)

Latest Update

Link to slide deck presented at UEG Week October 2023. 

This slide deck contains the results of the voting and final statements for Chapters 1 - 6.