RESEARCH - Pancreatitis in inflammatory bowel diseases

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J Clin Gastroenterol. 2010 Apr;44(4):246-53.

Pancreatitis in inflammatory bowel diseases.

Pitchumoni CS, Rubin A, Das K.

Abstract

Crohn's disease and ulcerative colitis, together popularly known as

inflammatory bowel disease (IBD), are characterized by a number of

extraintestinal manifestations. Although infrequent, acute

pancreatitis, and less often chronic pancreatitis, may occur as a

result of the disease itself or secondary to the medications used in

the treatment. The increased incidence of acute pancreatitis in

Crohn's disease can be explained based on the high predisposition to

cholesterol as well as pigment stones as a result of ileal disease,

anatomic abnormalities of the duodenum, immunologic disturbances

associated with IBD, and, above all, to the side effects of many

medications used in the treatment. Sulfasalazine, 5-aminosalicylic

acid, azathioprine, and 6-mercaptopurine are well known to cause acute

pancreatitis as a result of a possible idiosyncratic mechanism.

Crohn's disease and ulcerative colitis share many clinical

manifestations and treatment modalities. Nonspecific elevations of

serum pancreatic enzymes in IBD make it difficult to avoid over

diagnosis of acute pancreatitis, particularly in patients with Crohn's

disease who suffer from abdominal pain often. The IBD-pancreas

association is further reflected in many reports of exocrine as well

as endocrine pancreatic insufficiency.

PMID: 20087199

http://www.ncbi.nlm.nih.gov/pubmed/20087199

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