Prevalence of Exocrine Pancreatic Insufficiency in Patients with Irritable Bowel Syndrome Predominant Diarrhea

Background: With a global prevalence of 7.6-10.8% according to Rome IV criteria, irritable bowel syndrome (IBS) is among the most common illnesses seen in clinical practice. It can be challenging to diagnose pancreatic disease in its early stages, which is why some individuals with irritable bowel syndrome may actually have other underlying disorders. Patients may be diagnosed with irritable bowel syndrome (IBS) based on the Rome IV criteria; however, there may be some overlap in symptoms with exocrine pancreatic insufficiency (EPI). Aim and objectives: To determine how often exocrine pancreatic insufficiency is in individuals suffering from irritable bowel syndrome with diarrhea as its major symptom (IBS-D). Subjects and methods: From August 2022 through January 2024, one hundred individuals participated in the present cross-sectional study that took place in an outpatient environment. The Ethics Committee of the Faculty of Medicine at Al-Azhar University in Cairo, Egypt, gave its blessing before the research could begin. Results: Among the 100 patients analyzed, 63% were male, and the mean age was 48.4 years. Thirty percent of patients with inadequate fecal Elastase (FE) had EPI. Fatty pancreas was the main CT finding (20%) in FE insufficient patients. Among FE insufficient patients, those with fatty pancreas (n=6) were significantly older. Conclusion: Rome IV criteria for irritable bowel syndrome diarrhea type are met by 30% of patients with exocrine pancreatic insufficiency (EPI). Fatty pancreas is the main CT pancreatic protocol finding in FE insufficient patients. Older patients are at a higher risk of fatty pancreas in FE insufficient patients.