Study reveals link between increased spirit consumption and acute pancreatitis

Drinking just one 4cl measure of spirits can increase the risk of an acute attack of pancreatitis, but wine or beer does not appear to have the same effect, according to a study published online by BJS, the British Journal of Surgery. The study suggests that there are constituents in spirits that are not present in wine and beer and that they can cause acute pancreatitis, either on their own or in combination with alcohol.

Researchers from the Karolinska Institutet in Sweden followed 84,601 people from 46 to 84 years of age from the general population in Vastmanland and Uppsala for a median of ten years. During that time 513 developed acute pancreatitis.

"Our study revealed a steady increase between each measure of spirits a person drank on one occasion and the risk of having an acute attack of pancreatitis, starting at just under ten per cent for one 4cl drink" says lead author Dr Omid Sadr-Azodi.

"For example, drinking 20cl of spirits - five standard Swedish measures - on a single occasion increased the risk of an acute episode by 52 per cent and the risk then continued to increase at that rate for every five additional units consumed. But drinking more than five 15cl glasses of wine or five 33cl beers on one occasion did not increase the risk.

"We also discovered that the average monthly consumption of alcohol did not increase the risk. However, it is important to point out that most of the people included in our study drank alcohol within acceptable ranges, consuming one to two glasses a day."  

The authors were keen to investigate the affect that different types of alcohol had on acute pancreatitis after noticing that incidence rates declined in Sweden when spirits sales declined, despite increased sales of wine and beer. A similar pattern was observed in Finland.

Key findings of the study included:    

• In 56 per cent of cases the cause of the acute pancreatitis was alcohol-related or of uncertain or unknown origin (66 per cent were men) and in 44 per cent of cases it was gallstone related (48 per cent were men). The average age of the patients with pancreatitis was 64 years.

• Single occasion alcohol consumption, including wine, beer and spirits, was highest in males and younger patients.

• High single occasion spirits consumption was associated with higher levels of diabetes (nine per cent) than low alcohol consumption (six per cent)

• People who had never smoked, were more highly educated and regularly ate fruit and vegetables were less likely to drink large quantities of beer and spirits.

• Eliminating patients with gallstone-related disease did not affect the overall results and only reduced the overall risk of an acute attack after consuming five measures of spirits from 52 per cent to 39 per cent.       

"When alcohol metabolises it induces oxidative stress and this in turn can lead to damaged pancreatic tissue" says Dr Sadr-Azodi.

"However research has shown that alcohol on its own is not sufficient to cause acute pancreatitis. Our study suggests that there are constituents in spirits that are not present in wine and beer and that they can cause acute pancreatitis, either on their own or in combination with alcohol."

The authors are calling for more research into the association between increased spirit consumption and acute pancreatitis, with a greater focus on constituents other than the alcohol.