title: Abstinence after first acute alcohol-associated pancreatitis protects against recurrent pancreatitis and minimizes the risk of pancreatic dysfunction.
abstract: OBJECTIVE
  To determine the recurrence of pancreatitis and subsequent pancreatic function in patients who stop drinking after the first episode of alcohol-associated pancreatitis.
  
  
  METHODS
  Of a total of 118 patients suffering from their first alcohol-associated pancreatitis, 18 (all men, age median 47 (27-71) years) met the inclusion criterion for abstinence during follow-up. The criterion for abstinence was alcohol consumption <24 g per 2 months (self-estimated), which is in line with questionnaires eliciting alcohol consumption and dependency (Alcohol Use Disorders Identification Test < 8 and Short Alcohol Dependence Data < 9). Recurrent attacks of acute pancreatitis were studied. Smoking, body mass index and laboratory tests detecting heavy consumption of alcohol were recorded. Blood and faecal tests were studied to assess endocrine and exocrine pancreatic function.
  
  
  RESULTS
  During a mean follow-up time of 5.15 (1.83-9.13) years and a total of 92.7 patient-years, there were no recurrent attacks of acute pancreatitis among the 18 abstainers. Two patients had diabetes prior to and one was diagnosed immediately after the first episode of acute pancreatitis. One patient had impaired glucose metabolism at 2 years. Two patients had low insulin secretion in glucagon-C-peptide test, one at 4 years and the other at 5 years. Only one patient (6%) maintained low elastase-1 activity during the abstinence follow-up. Of the 100 non-abstainers, 34% had at least one recurrence during the follow-up.
  
  
  CONCLUSIONS
  Regardless of the mediator mechanisms of acute alcoholic pancreatitis, abstinence after the first episode protects against recurrent attacks. Pancreatic dysfunction is also rare among abstinent patients.
authors.affiliation: 1School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Nikkola
authors.forename: Sari
authors.initials: S
authors.lastname: Räty
authors.forename: Johanna
authors.initials: J
authors.lastname: Laukkarinen
authors.forename: Hanna
authors.initials: H
authors.lastname: Seppänen
authors.forename: Riitta
authors.initials: R
authors.lastname: Lappalainen-Lehto
authors.forename: Satu
authors.initials: S
authors.lastname: Järvinen
authors.forename: Isto
authors.initials: I
authors.lastname: Nordback
authors.forename: Juhani
authors.initials: J
authors.lastname: Sand
mesh_terms: D000208:Acute Disease; D000428:Alcohol Drinking; D005500:Follow-Up Studies; D006801:Humans; D010186:Pancreatic Function Tests; D019512:Pancreatitis, Alcoholic / Q000517:prevention & control*; D055502:Secondary Prevention