Alcohol Abuse and Pancreatic Diseases: An Overview.
BACKGROUND
Alcohol is one of the etiological factors of chronic pancreatitis and there is evidence that acute pancreatitis is the first episode of preexisting chronic pancreatitis and is sometimes not evident from a clinical point of view. The diagnosis of acute pancreatitis is based on the presence of abdominal pain, serum increase of pancreatic enzymes or their presence in urine and/or the presence of alterations of the pancreas imaging.


OBJECTIVE
To revise actual knowledge on the relationship between alcohol use and pancreatic diseases benign as well as malignant.


RESULTS
In occasional drinkers, levels of serum amylase were found to be abnormally high in approximately 13% of subjects, while pancreatic isoamylase and lipase were found to be abnormally high in serum in only 2%. The reason might be related to the fact that alcohol can affect the salivary glands. In chronic alcoholics without abdominal pain, amylase and lipase in serum are elevated in 14% of subjects and, in patients with alcoholic acute pancreatitis, pancreatic amylase and isoamylase are elevated in 94% of cases and lipase is generally more sensitive (100% of cases).


CONCLUSIONS
Chronic abuse of alcohol, but not occasional alcoholic intoxication, causes pancreatic damage. Regarding pancreatic neoplasms, the role of alcohol is under debate in ductal pancreatic adenocarcinoma as well as in pancreatic neuroendocrine tumors. Few relevant patents are also described in this review.
Pancreas Unit, Department of Digestive System, Sant'Orsola-Malpighi Hospital, Via Massarenti 9, 40138 Bologna, Italy. raffaele.pezzilli@aosp.bo.it.
Raffaele
R
Pezzilli
D000208:Acute Disease; D000428:Alcohol Drinking / Q000009:adverse effects*; D000437:Alcoholism / Q000150:complications*; D000681:Amylases / Q000097:blood; D000818:Animals; D063425:Binge Drinking / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D004796:Clinical Enzyme Tests; D006801:Humans; D008049:Lipase / Q000097:blood; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D019512:Pancreatitis, Alcoholic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D015854:Up-Regulation
D015415:Biomarkers; D008049:Lipase; C518354:PNLIP protein, human; D000681:Amylases