Chronic alcoholism is a well-known etiologic factor associated with chronic and irreversible pancreatic and liver disorders. There is a correlation between increased ethanol consumption through many years and the risk of developing chronic pancreatitis (CP). An excessive consumption of alcohol is also associated with liver cirrhosis (LC), again with a correlation between increased ethanol consumption and the risk of LC. In clinical practice, the coincidence of both diseases, LC and CP, is rare. Furthermore, these two diseases do not share risk factors apart from alcohol consumption.
A research group leaded by Luis Aparisi, form Hospital Clínico Universitario studied the possible association between CP and LC of alcoholic etiology. They compared clinical, functional, morphological and biochemical parameters in alcoholic subjects with a definitive diagnosis of CP or LC and this will be published on October 28, 2008 in the World Journal of Gastroenterology.
In their study, one hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed.
They found that in patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhoea as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% cases, and elastase-1 test was altered in only 7% and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal haemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients.
Their result indicated that there was a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogeny.
Reference: Aparisi L, Sabater L, Del-Olmo J, Sastre J, Serra MA, Campello R, Bautista D, Wassel A, Rodrigo JM. Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects? World J Gastroenterol 2008; 14(40): 6171-6179 http://www.wjgnet.com/1007-9327/14/6171.asp
Correspondence to: Dr. Luis Aparisi, Liver Unit, Hospital Clínico Universitario, Avda. Blasco Ibañez 17, Valencia 46010, Spain. aparisi_lui@gva.es Telephone: +34-963862600 Fax: +34-963862644
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2003-2000 IF: 3.318, 2.532, 1.445 and 0.993. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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World Journal of Gastroenterology