Chronic pancreatitis in women typically not related to alcohol use

Women were significantly less likely to have an alcohol-related etiology.
Women were significantly less likely to have an alcohol-related etiology.

Chronic pancreatitis is significantly less likely to have an alcohol-related etiology in women than in men, according to research published in Pancreas.

Chronic pancreatitis has long been considered a disease that occurs most frequently in alcoholic men, but recent data “suggest its etiology to be complex,” noted lead author Joseph Romagnuolo, MD, from the Digestive Disorders Center, Medical University of South Carolina, Charleston, and colleagues. To better understand chronic pancreatitis in women, the researchers compared data on women and men with the disease from a large, prospective, multicenter U.S. cohort—the NAPS2 Continuation and Validation study. Patients and their physicians completed questionnaires regarding demographics, etiology, risk factors, phenotype, and treatment.

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A total of 521 cases were included in the analysis; 45% were women. The investigators found that women were significantly less likely to have an alcohol-related etiology (30% vs 58.5% for men) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18% for men; obstructive, 12% vs 2.4% for men; and genetic, 12.8% vs 7.3% for men). Findings were similar for men and women regarding demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, chronic pancreatitis–related disability, and use of medical therapies. Sphincterotomy (biliary, 33% vs 24% in men; pancreatic, 38% vs 28% in men) was performed more frequently in women, and cyst/pseudocyst operations were more common in men (6.6% vs 2.6% in women).

“Most chronic pancreatitis cases in women are from nonalcoholic etiologies,” concluded Dr Romagnuolo's group. “In contrast to many other chronic diseases, clinical phenotype of chronic pancreatitis is determined by the disease and is independent of sex.”

Reference

  1. Romagnuolo J, Talluri J, Kennard E, et al. Clinical profile, etiology, and treatment of chronic pancreatitis in North American women: analysis of a large multicenter cohort. Pancreas. 2016;45(7):934-940. doi: 10.1097/MPA.0000000000000616.
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