Contrary to popular belief, not all cases of chronic pancreatitis are alcohol-induced

The relative rate of alcohol-related chronic pancreatitis (CP) is lower when compared to other causes, according to a new study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute. Patients with no identifiable cause for their disease as well as those with non-alcohol-related causes represent an unexpectedly large subgroup, particularly among women.

"One of the more remarkable observations is that in more than 50 percent of patients, alcohol was not considered as the causative factor of chronic pancreatitis," said Gregory A. Coté, MD, MS, of Indiana University School of Medicine and lead author of this study. "Future analyses will likely identify previously unrecognized genetic factors and/or interaction between genes and environmental factors as potential explanations of disease development. In the meantime, the era of dismissing all cases of chronic pancreatitis as alcohol-induced has undoubtedly come to a close."

Doctors studied data from patients with CP and controls enrolled in the North American Pancreatitis Study, which was designed to further the understanding of the role of gene-environment interactions in patients with recurrent acute pancreatitis and CP. Among the groups, 44.5 percent of patients had CP due to alcohol consumption, 26.9 percent had non-alcohol related CP, and 28.6 percent had CP of unknown cause.

Doctors observed that the current etiologic profile of CP patients evaluated at U.S. referral centers is quite different from historical data. Although alcohol remains the most common cause, a larger fraction of patients was considered to have non-alcoholic etiologies, and in more than a quarter of patients, no identifiable cause of disease (i.e., idiopathic CP) was apparent. Among the risk factors assessed, smoking was independently associated with idiopathic CP.

Pancreatitis usually begins as a sudden attack. When the pancreas becomes inflamed, its digestive enzymes attack the tissue that produces them. One of these enzymes, called trypsin, can cause tissue damage and bleeding, which may cause the pancreas tissue cells and blood vessels to swell. In some cases, the attacks may recur frequently over time, which is known as CP. The onset of CP remains hard to define. This condition can be caused by alcohol, smoking and a multitude of other factors.