It is possible to treat exocrine pancreatic insufficiency (EPI) successfully. However, without treatment, EPI can cause serious complications and even death.

EPI occurs when the pancreas fails to make enough enzymes needed to digest food.

People with EPI have an increased risk of cardiovascular events and malnutrition. Those with EPI may also have other conditions, such as chronic pancreatitis, that can increase the risk of death.

Pancreatic enzyme replacement therapy (PERT) is available to treat EPI and can improve the quality of life for people living with the condition.

People can manage and treat EPI successfully, and those living with the condition can have a good quality of life. However, left untreated, EPI can lead to serious complications and, in some cases, be fatal.

EPI has a significant association with cardiovascular events in people with chronic pancreatitis. Cardiovascular disease is a leading cause of death worldwide.

Among those with chronic pancreatitis, 2018 research suggests that EPI is a significant independent risk factor for death.

People living with EPI are also at heightened risk for malnutrition. A 2018 study suggests that people with chronic pancreatitis and EPI have high rates of malnutrition. If left unaddressed, malnutrition can cause serious complications and even death.

To add to the complexity, many people with EPI also have other underlying conditions that may make malnutrition particularly dangerous.

Chronic pancreatitis is a common cause of EPI. People with chronic pancreatitis and malnutrition have higher rates of mortality.

Pancreatic cancer is another cause of EPI. In people with this cancer, malnutrition can cause lower rates of survival.

People living with EPI may also have conditions that can affect life expectancy.

Studies have shown males with chronic pancreatitis have a mortality rate 4.3 times higher than the general population, and females have a 4.5 times higher mortality rate.

Those living with cystic fibrosis may also experience EPI, and cystic fibrosis can affect life expectancy. The life expectancy for a person with cystic fibrosis is lower than the general population.

A person with cystic fibrosis born between 2015 and 2019 has a life expectancy of 46 years. By contrast, the global general life expectancy for a person born in 2015 is 72 years.

EPI does not cause pancreatic cancer, but people with pancreatic cancer may also have EPI.

Pancreatic cancer can also cause EPI. This may be due to the tumor blocking the pancreatic duct or as a result of treatment that removes all or part of the pancreas.

Both pancreatic cancer and EPI have a common risk factor: chronic pancreatitis. This is inflammation of the pancreas that worsens over time and can cause permanent damage to the pancreas.

Several other factors can cause EPI, and not everyone with EPI will have or develop cancer.

With proper treatment, it is possible for a person living with EPI to have a good quality of life. Treatment for EPI involves PERT to replace the enzymes the pancreas no longer produces.

Without treatment, complications can occur. It can also be fatal.

Numerous factors contribute to a person’s life expectancy.

In the United States, life expectancy is shorter than in most other high-income countries.

Research from 2020 suggests that some behavioral risk factors could shorten life expectancy. These include:

  • smoking
  • being physically inactive
  • having obesity
  • drinking alcohol

The research notes that men and women at the ages of 50, 60, and 70 years who have two or more of the above risk factors could live up to 12 years less than people without any of the above risk factors.

Many of these risk factors can also contribute to EPI. Both alcohol consumption and smoking are known as factors that can contribute to the progression of EPI.

Chronic pancreatitis is a common cause of EPI. Heavy alcohol use and smoking are both associated with chronic pancreatitis and may shorten life expectancy.

Many of the underlying conditions associated with EPI can shorten life expectancy. These include:

  • pancreatic cancer
  • cystic fibrosis
  • chronic pancreatitis

Many of the causes of EPI can cause irreversible, permanent damage to the pancreas.

Chronic pancreatitis is the most common cause of EPI and can cause significant damage to the pancreas. Pancreatic insufficiency occurs when more than 90% of the pancreas is damaged.

This damage is not repairable, and those with chronic pancreatitis and EPI will require ongoing treatment.

People with cystic fibrosis can have an inflamed pancreas from birth. EPI can occur in more than 80% of people with cystic fibrosis, beginning early in life.

Cystic fibrosis has no cure, and those with CF and EPI will require ongoing treatment.

PERT is currently the only available treatment for EPI. While it will not cure EPI, PERT can help those with EPI manage the condition and improve their quality of life.

It is essential to begin treating EPI as soon as a person receives a diagnosis. Untreated, EPI can cause several potentially serious complications. These include:

  • malnutrition
  • vitamin and mineral deficiencies
  • unintended weight loss
  • fatigue
  • weakness
  • getting sick more regularly
  • extended recovery times from illness
  • poor appetite
  • difficulty concentrating
  • poor wound healing
  • low moods
  • osteoporosis

Those who have EPI and do not receive treatment may also be at risk of death.

It is possible to treat EPI, and those with the condition can have a good quality of life. However, left untreated, EPI can cause serious complications and even death.

Some people with EPI may have other underlying conditions that may shorten life expectancy. These include cystic fibrosis, chronic pancreatitis, or pancreatic cancer.

Currently, the only treatment for EPI is PERT. This will not cure EPI but can help people effectively manage the condition.