Unlike patients with alcoholic hepatitis, patients with acute alcoholic pancreatitis seldom come into the hospital in an intoxicated state.
Long-term history of heavy drinking induces increases in the serum pancreatic enzymes.
A longer history of heavy drinking increases pancreatitis-associated protein profiles during the withdrawal period.
Dr Isto Nordback and colleagues investigated the role of withdrawal in triggering acute alcoholic pancreatitis.
The researchers studied the time-course of development of the first symptoms of the first acute alcoholic pancreatitis.
The researchers included 100 patients, of which 85 with a mean age of 46 years with first acute alcoholic pancreatitis.
|43% of the patients developed symptoms during the first day after cessation|
|Scandanavian Journal of Gastroenterology|
The patients were asked 3 different questions in an attempt to clarify the same issue.
The first question included whether they had stopped continuous drinking before the start of the acute abdominal pain that later led to hospitalization.
The second question addressed the issue whether the patients already stopped continuous drinking before starting to experience nausea or vomiting.
Question 3 posed by the team was about how many hours after taking the last drop of alcohol did the patient start to feel pain.
The researchers evaluated the amount of alcohol that the patients consumed during the past week and during the past 2 months.
The severity of the pancreatitis was assessed by serum C-reactive protein concentration, and the presence of necrosis.
The team also assessed pancreatitis severity by the development of pancreatic complications, the length of stay in hospital and in the intensive care unit.
The research team reported that 85 patients were able to respond to the questions.
Of the responding patients, 69% had developed pain and 91% nausea/vomiting only after they had already stopped continuous drinking.
The team noted that 29% of the patients developed some symptoms before stopping drinking.
The researchers observed that 43% of the patients developed symptoms during the first day after cessation.
The team also found that 28% of patients developed symptoms later, mainly during the second day of cessation of drinking.
Symptoms were found to be dependent on the amount of alcohol consumed during the previous 2 months and in the past week.
Dr Nordback's team concludes, “In the majority of patients with first acute alcoholic pancreatitis, the symptoms begin during the early withdrawal period.”
“The withdrawal period might be more important than previously emphasized in the development of acute alcoholic pancreatitis.”