title: Clinical Profile, Etiology, and Treatment of Chronic Pancreatitis in North American Women: Analysis of a Large Multicenter Cohort.
abstract: Historically, chronic pancreatitis (CP) was considered a disease of alcoholic males, but recent data suggest its etiology to be complex. To better understand CP in women, we compared data on women and men with CP in a large, prospectively ascertained multicenter US cohort.
  
  
  
  Patients with CP enrolled in the NAPS2 Continuation and Validation study were studied. Information on demographics, etiology, risk factors, phenotype, and treatment(s) used was obtained from detailed questionnaires completed by the patients and physicians.
  
  
  
  Of 521 cases, 45% were women. Women were significantly (P < 0.05) less likely to have alcohol etiology (30% vs 58.5%) and more likely to have nonalcoholic etiologies (idiopathic, 32% vs 18%; obstructive, 12% vs 2.4%; genetic, 12.8% vs 7.3%). Demographics, pain experience, morphologic findings, exocrine and endocrine insufficiency, CP-related disability, and use of medical therapies were mostly similar in both sexes. Sphincterotomy (biliary, 33% vs 24%; pancreatic, 38% vs 28%; P < 0.05) was performed more frequently in women, whereas cyst/pseudocyst operations were more common in men (6.6 vs 2.6%, P = 0.02).
  
  
  
  Most CP cases in women are from nonalcoholic etiologies. In contrast to many other chronic diseases, clinical phenotype of CP is determined by the disease and is independent of sex.
authors.affiliation: From the *Digestive Disorders Center, Medical University of South Carolina, Charleston, SC; †Department of Medicine, University of Pittsburgh Medical Center; ‡Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; §Department of Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA; ∥Department of Medicine, Indiana University School of Medicine, Indianapolis, IN; ¶Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, MO; #Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH; **Department of Medicine, Mayo Clinic, Jacksonville, FL; ††Department of Medicine, University of Florida College of Medicine, Gainesville, FL; ‡‡Department of Medicine, University of Wisconsin School of Medicine, Milwaukee, WI; §§Department of Medicine, Brigham and Women's Hospital, Boston, MA; ∥∥Department of Medicine, Griffin Hospital, Derby, CT; ¶¶Department of Medicine, University of Alabama at Birmingham Hospital, Birmingham, AL; and ##Department of Medicine, University of Michigan School of Medicine, Ann Arbor, MI.
authors.forename: Joseph
authors.initials: J
authors.lastname: Romagnuolo
authors.forename: Jyothsna
authors.initials: J
authors.lastname: Talluri
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kennard
authors.forename: Bimaljit S
authors.initials: BS
authors.lastname: Sandhu
authors.forename: Stuart
authors.initials: S
authors.lastname: Sherman
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Cote
authors.forename: Samer
authors.initials: S
authors.lastname: Al-Kaade
authors.forename: Timothy B
authors.initials: TB
authors.lastname: Gardner
authors.forename: Andres
authors.initials: A
authors.lastname: Gelrud
authors.forename: Michele D
authors.initials: MD
authors.lastname: Lewis
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Forsmark
authors.forename: Nalini M
authors.initials: NM
authors.lastname: Guda
authors.forename: Darwin L
authors.initials: DL
authors.lastname: Conwell
authors.forename: Peter A
authors.initials: PA
authors.lastname: Banks
authors.forename: Thiruvengadam
authors.initials: T
authors.lastname: Muniraj
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Wisniewski
authors.forename: Ye
authors.initials: Y
authors.lastname: Tian
authors.forename: C Mel
authors.initials: CM
authors.lastname: Wilcox
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Anderson
authors.forename: Randall E
authors.initials: RE
authors.lastname: Brand
authors.forename: Adam
authors.initials: A
authors.lastname: Slivka
authors.forename: David C
authors.initials: DC
authors.lastname: Whitcomb
authors.forename: Dhiraj
authors.initials: D
authors.lastname: Yadav
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult