Although alcohol consumption is known to be associated with chronic pancreatitis, new evidence indicates that a threshold of five or more drinks per day is required to significantly raise risk; however, most patients with chronic pancreatitis do not drink this amount, according to a report in the June 8 issue of Archives of Internal Medicine. In addition, smoking is an independent, dose-dependent risk factor.
"Chronic pancreatitis is an inflammatory syndrome of the pancreas characterized by progressive parenchymal fibrosis [scarring of the organ], maldigestion, diabetes mellitus and pain," the authors write as background information in the article. "Recurrent acute pancreatitis [acute pancreatitis that occurs on two or more occasions and may become chronic] and chronic pancreatitis are associated with alcohol consumption and cigarette smoking. The etiology of recurrent acute pancreatitis and chronic pancreatitis is complex, and effects of alcohol and smoking may be limited to specific patient subsets."
Dhiraj Yadav, M.D., M.P.H., of the University of Pittsburgh, and colleagues in the North American Pancreatic Study Group examined the current prevalence of alcohol use and smoking and their association with pancreatitis in patients evaluated at U.S. referral centers. Between 2000 and 2006, 1,000 patients (540 with chronic pancreatitis and 460 with recurrent acute pancreatitis) were enrolled in the North American Pancreatitis Study 2 (NAPS2), as were 695 healthy controls. All participants (average age 49.7) reported their alcohol consumption and smoking habits.
About one-fourth of both controls and patients were lifetime abstainers. Among those with chronic pancreatitis, 38.4 percent of men and 11 percent of women were very heavy drinkers (five or more drinks per day), compared with 16.9 percent of men and 5.5 percent of women with recurrent acute pancreatitis and 10 percent of men and 3.6 percent of women in the control group.