[Alcohol and pancreatic diseases].
The epidemiological correlation between the incidence of acute and chronic pancreatitis and the amount of alcohol intake is well known. In contrast to alcoholic cirrhosis, there appears to be no threshold above which alcohol intake is associated with an increased risk to develop pancreatitis, but instead the risk increases with increasing consumption of alcohol in a logarithmic fashion. The incidence of alcoholic pancreatitis has continuously increased in recent decades and exceeds the combined incidence from all other causes. In very recent years, this increase appears to slow down. The pathophysiology of acute alcoholic pancreatitis is not known in detail. Alcohol may directly damage the acinar cell or the ductal epithelium. The pathogenesis of chronic pancreatitis involves an increase of protein concentration in pancreatic secretion leading to protein precipitations which may finally form calculi. The pancreas-stone-protected may play a crucial role in the lithogenic process. Little is currently known about the influence of alcohol on motility and pressure in biliary and pancreatic ducts. The course of alcoholic pancreatitis is more progressive and severe compared with nonalcoholic pancreatitis and markedly depends on discontinuation of alcohol consumption. The incidence of pancreatic carcinoma has continuously increased during the last 20 years in industrialized countries. Although diagnosis has been improved, long-term survival continues to be dismal. Several epidemiological studies have shown that there is no major correlation between alcohol consumption and the risk to develop pancreatic carcinoma.
Niederau
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Medizinische Klinik und Poliklinik, Universität Düsseldorf.
Lüthen
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D000437:Alcoholism / Q000150:complications*; D006801:Humans; D010179:Pancreas / Q000187:drug effects; D010190:Pancreatic Neoplasms / Q000209:etiology*; D010195:Pancreatitis / Q000209:etiology*
Alkohol und Pankreaserkrankungen.