The coincidence of alcoholic liver cirrhosis and chronic pancreatitis

Czech version

Authors: J. Špičák ¹; A. Pulkertová ¹; I. Králová-Lesná ²; P. Suchánek ²; M. Vitásková ³; V. Adámková ³
Authors‘ workplace: Klinika hepatogastroenterologie IKEM Praha, přednosta prof. MUDr. Julius Špičák, CSc. ¹; Pracoviště experimentální medicíny IKEM Praha, přednosta prof. MUDr. Luděk Červenka, CSc., MBA ²; Pracoviště preventivní kardiologie IKEM Praha, přednostka doc. MUDr. Věra Adámková, CSc. ³
Published in: Vnitř Lék 2011; 57(12): 1045-1052
Category: 70th birthday of prof. MUDr. Petr Dítě, DrSc.

Overview

Introduction, study aim:
Health consequences of alcoholism vary and include a wide range of pathological conditions from mental disorders to disorders of various parenchymatous organs. There are many differences between alcohol abusers, from the way they abuse alcohol to the nature of bodily harm. The aim of this prospective study was to map and correlate organ involvement with the type of alcohol abuse and smoking and dietary habits.

Methods:
A prospective study analyzing a questionnaire on alcoholism, smoking, diet and lifestyle habits completed by 146 patients with liver cirrhosis and chronic pancreatitis.

Results:
Of the 80 liver cirrhosis patients with the mean age of 47.5 year (23–60 years, SD 8.58), 64 were men and 16 (20%) were women. Of the 60 chronic pancreatitis patients with the mean age of 37.8 year (23–60 years, SD 9.66), 60 were men and 6 (9.1%) were women. The mean daily alcohol intake was 57.7 g in patients with cirrhosis and 63.7 g per day in patients with pancreatitis. The first contact with alcohol before 15th year of age was reported by 25.8% of patients with pancreatitis and 8.8% of patients with cirrhosis. Age under 30 years as the period with the largest intake of alcohol was reported by 43.6% of patients with pancreatitis and 20.3 % of patients with cirrhosis. There was a statistically significant difference in the type of alcohol used; patients with pancreatitis predominantly drank beer. 16.7% of patients with pancreatitis and 3.7 % of patients with cirrhosis started to smoke before 15th year of age. 66.7% of patients with pancreatitis and 40% of patients with cirrhosis left education before achieving collage state exam, 9.1% of patients with pancreatitis and 25% of patients with cirrhosis had university education. Cirrhosis was diagnosed in 11 (16.7%) patients with chronic pancreatitis. In all patients, this was functional disorder Child-Pugh stage A, decompensation occurred in 54.5% of patients. Portal hypertension was diagnosed in 72.7% of patients and thrombosis of v. portae or v. lieanlis in 12 patients. Bleeding from gastroesophageal varices occurred in 1 patient with chronic pancreatitis, liver cirrhosis and v. portae thrombosis. Chronic pancreatitis was diagnosed in 2 (2.5%) patients with liver cirrhosis. With respect to comorbidities, chronic obstructive bronchopulmonary disease and ischemic heart disease was significantly more frequent in patients with chronic pancreatitis.

Conclusion:
There are differences in social-behavioural background of both relatively common organ disorders. Chronic pancreatitis is more prevalent in people with lower education. The first contact with alcohol and regular abuse occur at younger age, smoking is also more frequent, with earlier onset. Both diseases rarely occur concurrently and simultaneous decompensation of both organs is not seen. We could speculate that early exposition to the known aetiopathogenic factors affect primarily pancreas. The rare concurrence of both diseases, particularly of their advanced stages, opposes all known theories.

Key words:
alcoholic chronic pancreatitis – alcoholic liver cirrhosis

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