Myths and realities about alcohol and smoking in chronic pancreatitis

Singhvi, Ajay; Yadav, Dhiraj

doi:10.1097/mog.0000000000000466

Cited by 33 publications

(24 citation statements)

References 52 publications

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“…99 What is sobering is that approximately 20%-40% of children with ARP will quickly progress, within 2-5 years of the start of AP, to a diagnosis of CP. 13,100 Although there are currently few data on the role of smoking or alcohol on pediatric pancreatitis progression, based on the alarming rates reported with these toxins in adults with pancreatitis, 101 we generally proscribe their use in children with ARP. Longitudinal studies are necessary in patients diagnosed with pancreatitis during childhood to ascertain the natural history of progression from ARP to CP, then EPI and diabetes, and potentially pancreatic cancer and, importantly, to identify the determinants that accelerate and, conversely, retard progression.…”

Section: Prognosis and Natural Historymentioning

confidence: 99%

Pancreatitis in Children

2019

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Acute, acute recurrent, and chronic forms of pancreatitis have been increasingly diagnosed in children in the past 2 decades. Risk factors in the pediatric group are broad and appear to be strikingly different compared with the adult cohort. However, the disease burden and impact on quality of life are surprisingly similar in children and adults. This review summarizes the definitions, epidemiology, risk factors, diagnosis, and management of pediatric pancreatitis, identifies features that are unique to the childhood-onset disease, identifies gaps, and proposes recommendations for future opportunities.

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Section: Prognosis and Natural Historymentioning

confidence: 99%

Pancreatitis in Children

2019

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“…Although excessive alcohol consumption has long been known to be the primary cause of chronic pancreatitis (CP), its contribution to the etiology and development of pancreatitis is still shrouded in mystery in many respects [ 1 , 2 , 3 , 4 ]. Since the discovery of the first CP-causing variant, namely c.365G>A (p.Arg122His) in the PRSS1 gene (MIM# 276000; encoding cationic trypsinogen) [ 5 ], one new puzzle has emerged pertaining to whether or how a particular genetic risk factor interacts with alcohol consumption to cause CP.…”

Section: Introductionmentioning

confidence: 99%

Scale and Scope of Gene-Alcohol Interactions in Chronic Pancreatitis: A Systematic Review

Chen

Herzig

Génin

et al. 2021

Genes

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Background: Excessive alcohol consumption has long been known to be the primary cause of chronic pancreatitis (CP) but genetic risk factors have been increasingly identified over the past 25 years. The scale and scope of gene-alcohol interactions in CP nevertheless remain unclear. Methods: All studies that had obtained genetic variant data concurrently on alcoholic CP (ACP) patients, non-ACP (NACP) patients and normal controls were collated. Employing normal controls as a common baseline, paired ORACP and ORNACP (odds ratios associated with ACP and NACP, respectively) values were calculated and used to assess gene-alcohol interactions. Results: Thirteen variants involving PRSS1, SPINK1, CTRC, CLDN2, CPA1, CEL and CTRB1-CTRB2, and varying from very rare to common, were collated. Seven variants had an ORACP > ORNACP, which was regarded as an immediate indicator of gene-alcohol interactions in CP. Variants with an ORACP < ORNACP were also found to interact with alcohol consumption by virtue of their impact on age at first pancreatitis symptoms in ACP. Conclusions: This study revealed evidence for extensive gene-alcohol interactions in CP. Our findings lend support to the hypothesis that alcohol affects the expression of genetically determined CP and highlight a predominant role of weak-effect variants in the development of ACP.

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“…PERT use increased to 55.7% in this subgroup of 9,541 although adequate dosing remained low at 36.9%. Second, although the prevalence of alcohol use in CP cohorts is 44%‐68%, 10 the authors reported alcoholism in just 20%. This could reflect under‐reporting of alcohol consumption, but also implies over‐estimation of CP diagnosis thereby offsetting the PERT requirement.…”

Section: Chronic Pancreatitis (N = 37 061) Pancreatic Cancer (N mentioning

confidence: 94%