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A number of causes for chronic pancreatitis (CP) have been identified:

• Alcoholism - may account for as much as 70% of all cases of chronic pancreatitis. The development of chronic pancreatitis is correlated with the quantity and duration of alcohol intake but not with the type of alcohol or pattern of consumption.
• Tobacco use
• Gallstones
• Pancreatic duct obstruction due either to strictures or stones.
• Hyperparathyroidism - A condition marked by overproduction of a hormone produced by the parathyroid glands that results in elevated levels of calcium (hypercalcemia) and causes an increase in calcium secretion by the pancreas. The mechanisms are not clearly understood regarding the resulting development of CP.
• Hyperlipidemia - increased levels of lipids/fats in the bloodstream.
• Trauma to the abdominal area - pancreatic injury may result in inflammation, pseudocysts, or strictures (constriction of the ducts), all of which may impact normal ductal function of the pancreas.
• Congenital disorders such as pancreas divisum (failure of the internal pancreatic ducts to fuse) - this occurs in approximately 10% of the population. The structural change affects the drainage of specific ducts and may cause CP in a subset of this population
• Alpha 1-antitrypsin deficiency - an enzyme deficiency that causes lung disease in adults and liver disease in adults and children.

Traditionally, alcohol has been considered to be the primary cause of chronic pancreatitis. However, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that the presence of gallstones is increasing rapidly as a major cause of chronic pancreatitis and that 80% of cases of chronic pancreatitis are caused by these two conditions. There is a known link between obesity and the formation of gallstones, however, it is not clear if the increase in incidence of gallstone-related pancreatitis is connected to the increasing rate of obesity in the general population.

Researchers at the University of Minnesota published an article in Surgical Clinics of North America in 2007, in which they noted that in one small study on CP, alcohol-based chronic pancreatitis accounted for only 16% of the cases of CP while idiopathic CP was attributed to approximately 60% of cases. Thus, in general, it appears that the etiology of CP may be changing and researchers are actively investigating this development.

For more information, please click on the following link: http://www.medifocus.com/abstracts.php?gid=GS007&ID=18053843

Genetics and Chronic Pancreatitis

There is growing evidence of a genetic component in the development of CP. Recent findings include:

• Chronic pancreatitis has been associated with the mutation of a gene identified as CFTR. In young patients who develop CP, there are 2 CFTR mutations in addition to a mutation in a gene identified at SPINK1.
• Hereditary pancreatitis has been traced to mutations of gene 7.
• Cystic fibrosis is a genetic abnormality and, depending on the types of mutations, some CF patients develop chronic pancreatitis of varying intensities.
• Although 70-80% of the cases of chronic pancreatitis are caused by alcoholism, only approximately 10% of alcoholics develop chronic pancreatitis. This suggests that in the 10% who develop CP, there may be a genetic predisposition which is necessary in order for the condition to occur when combined with alcoholism.