Changing Trends in the Epidemiology of Pancreatitis in Rural Population: Study at a Tertiary Health Care Centre

Title: Changing Trends in the Epidemiology of Pancreatitis in Rural Population: Study at a Tertiary Health Care Centre

Authors: Shivani Battin, Dr Ninad Gadekar, Dr Gund

DOI: https://dx.doi.org/10.18535/jmscr/v5i2.120

Abstract

Introduction: Worldwide, over the last decade, yearly incidence of pancreatitis and related hospitalizations have increased ^[1]. Acute pancreatitis is the most common cause of GI related hospitalizations in the world, with more than 274,000 hospitalizations in 2012^[1].The yearly incidence of AP in the United States is approximately 70-80 new cases per 100,000 population ^[2] and has increased over the last decade. Chronic pancreatitis, although lower in incidence, significantly reduces the patients’ quality of life. According to the data presented by the Department of the Welfare in 2005 ^[3], the rate of patients discharged for chronic pancreatitis is 32.9/100,000 hospitalized patients. True incidence and prevalence of pancreatitis in India is unknown since, it being difficult to establish an accurate diagnosis, a number of cases are misdiagnosed or are not recorded or reported. Nevertheless, in 2004, a high prevalence of chronic pancreatitis in Southern India (114-200/100,000 population) was registered in a study of chronic pancreatitis in the Asia-Pacific region ^[4].

Material and Method: A retrospective cross-sectional, non-interventional, analytical hospital based study on the proven cases of pancreatitis admitted and treated in Vikhe Patil Hospital, a tertiary level health care centre was conducted. A specific period of 6 months from November 2014 to April 2015 formed the sample under study. The study was started after the approval from the Institutional Ethics Committee by collecting the medical records of the said cases from the Medical Records Department. These records included the history, clinical profile, biochemical and radiological reports, treatments administered, complications and final outcome of the respective cases. The data available in these records was organised and analysed.

Results: Results were analysed based on the following parameters: 1. Demographic data, 2. Etiological factors, 3. Clinical presentation with reference to diagnosis, 4. Investigations, 5. Treatment and final outcome, 6.Complications.

On analysis of the results, this study reaffirms that alcohol is the major factor associated with pancreatitis in the rural population of Maharashtra in India.

Conclusion: The incidence and epidemiology of pancreatitis in Indian settings in under-studied. This report presents the relevant observations noted at a tertiary health care centre comparing them with the available international studies. Here, a hospital based cross-sectional analytical study about the changing epidemiological and clinical pattern of pancreatitis was undertaken. This study comprised of a relatively small sample size which is a great limitation for arriving at definite conclusions; for this, further studies are required both epidemiological and clinical.

Keywords: Changing trends, Pancreatitis, Rural population, Tertiary health care centre.

References

1. 1. Peter Lee, Tyler Stevens; Acute Pancre-atitis. Cleveland Clinic 4th Annual Gastroenterology & Hepatology Symposium, February 2014.

2. Lankisch PG, Banks PA. Pancreatitis. New York: Springer; 1998.

3. Ministerodel Lavoro, della Salute e delle Politiche Sociali. Available online: http://www.ministerosalute.it/programmazione/sdo/ric_informazioni/sceltadia.jsp (accessed 14 July 2009).

4. Garg PK, TondonRK; Survey on chronic pancreatitis in the Asia-Pacific region. J Gastroenterol Hepatol 2004; 19:998-1004.

5. Moynihan B. Acute pancreatitis. Ann Surg 1925;81:132-42.

6. Raffaele Pezzilli, Antonio M. Morselli-Labate; Alcoholic Pancrea-titis: Pathoge-nesis, Incidence and Treatment with Special Reference to the Associated Pain. Int. J. Environ. Res. Public Health 2009, 6, 2763-2782; doi:10.3390/ijerph6112763.

7. Vallath Balakrishnan et al; Chronic Pancreatitis: A Prospective Nationwide Study of 1,086 Subjects from India.JOP. J Pancreas 2008;9(5):593-600.

8. FrossardJL, Steer ML, Pastor CM. Acute pancreatitis. Lancet. 2008; 371:143–52. PMID 18191686. {PubMed: 18191686}

9. GoldacreMJ, Roberts SE. Hospital admission for acute pancreatitis in an English population, 1963–98: database study of incidence and mortality. BMJ. 2004; 328:1466–9. PMID 15205290. {PubMed: 15205290} .

10. O'Farrell A, Allwright S, Toomey D, Bedford D, Conlon K. Hospital admission for acute pancreatitis in the Irish population, 1997 2004: could the increase be due to an increase in alcohol related pancreatitis? J Public Health (Oxf). 2007; 29:398–404. PMID 17998260. {PubMed: 17998260}

11. Spanier BW, Dijkgraaf MG, Bruno MJ. Trends and forecasts of hospital admissions for acute andchronic pancreatitis in the Netherlands. Eur J GastroenterolHepatol. 2008; 20(7):653–8. PMID18679068. {PubMed: 18679068}

12. Yadav D, Lowenfels AB. Trends in the epidemiology of the first attack of acute pancreatitis: asystematic review. Pancreas. 2006; 33:323–30. PMID 17079934. {PubMed: 17079934}

13. Gullo L; Alcohol and chronic pancreatitis: leading or secondary etiopathogenic role? JOP. J Pancreas 2005:6:68-72 PMID15650289.

14. Hyacinth M Irving, Andriy V Samokhvalov, JurgenRehm; Alcohol as a risk factor for pancreatitis: A systemic review and meta-analysis. Author manuscript; PMC 2012 March 12 JOP.;10(4):387–392.

15. Stella Yen, Chung-Cheng Hsieh, Brian MacMahon; Consumption of alcohol and tobacco and other risk factors for pancreatitis. Am. J. Epidemiol. (1982)116(3):407-414.

16. Lin, Yingsong et al; Cigarette smoking as a risk factor for chronic pancreatitis: A case-control study in Japan. Pancreas Aug, 2000 Vol.21-Issue 2: pp109-114.

17. Sarles H.; An international survey on nutrition & pancreatitis. Digestion 1973;9:389-403.

18. HariharanRegunath et al; Anthropometric measurements of nutritional status in chronic pancreatitis in India: comparison of tropical and alcoholic pancreatitis. Indian J Gastroenterol (March–April 2011)30(2):78–83DOI 10.1007/s12664-011-0093-9.

19. V Balakrishnan et al; Tropical pancreatitis –a distinct entity, or merely a type of chronic pancreatitis? Indian Journal of Gastroenterology 2006Vol.25 March – April.

20. Dhiraj Yadav, AB Lowenfels. The epidemicology of pancreatitis and pancreatic cancer. Gastroenterology. 2013 June; 144(6): 1252-1261. doi:10.1053/j.gastro.2013.01.068.

21. Verlaan M et al; Genetic polymorphisms in alcohol metabolizing enzymes and chronic pancreatitis. Alcohol Alcohol2004;39:20-4.

22. Maruyama et al.; Autoimmune pancreatitis can develop into chronic pancreatitis. Orphanet Journal of Rare Diseases 2014,9:77.

23. Das, S.K. et al; Alcohol: its health and social impact in India. Natl. Med. J. India 2006,1994-99.

24. Talamini G, Falconi M, Bassi C, Sartori N, Salvia R, Caldiron E, et al. Incidence of cancer in the course of chronic pancreatitis. Am J Gastroenterol 1999; 94:1255-60.

25. Lowenfels AB, Maisoneuve P, Cavallini G, AmmannRW, Lankisch PG, Anderson JR, et al. Pancreatitis and the risk of pancreatic cancer. N Engl J Med 1993; 328:1433-7.

26. Balthazar EJ, Robinson DL, MegibowAJ, RansonJHC. Acute pancreatitis: value of CT in establishing prognosis. Radiology 1990;174:331–6.

27. F. Anderson et al. Acute pancreatitis: Demographics, aetiological factors and outcomes in a regional hospital in South Africa. SAJS Vol 46, No. 3, August 2008: 83-86.

28. Mangal A, Kumar V, Panesar S, Talwar R, Raut D, Singh S. Updated BG Prasad socioeconomic classification, 2014: A commentary. Indian J Public Health 2015;59:42-4.

29. Rajendran SD (ed). Globalization and increasing trend of alcoholism. Community Health Cell, for the Asia Social Forum, 2–7 January 2003, Hyderabad, India.

30. Chakravarthy C. Community workers estimate of drinking and alcohol-related problems in rural areas. Indian J Psychol Med 1999;13:49–56.

31. M Bourliere, M Barthet, P Berthezene, J P Durbec, H Sarles. Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis? Gut, 1991, 32, 1392-1395.

32. D Premkumar. Etiological factors affecting the clinical features, prognosis and management of acute pancreatitis. ActaMedicaScientia 02 {01} (2015) www.asdpub/index.php/ams

33. Paul Georg Lankisch, MinotiApte, Peter A Banks. Acute Pancreatitis. Published Online January 21, 2015 http://dx.doi.org/10.1016/S0140-6736(14)60649-8.

34. Frulloni, L.; Gabbrielli, A.; Pezzilli, R.; Zerbi, A.; Cavestro, G.M.; Marotta, F.; Falconi, M.; Gaia, E.; Uomo, G.; Maringhini, A.; Mutignani, M.; Maison-neuve, P.; di Carlo, V.; Cavallini, G. Chronic pancreatitis: report from a multicenter Italian survey (Pan CroInf AISP) on 893 patients. Dig. Liver Dis. 2009, 41, 311-317.

35. Montalto, G.; Carroccio, A.; Soresi, M.; Ficano, L.; Notarbartolo, A. Chronic pancreatitis in Sicily. Preliminary reports. Ital. J. Gastroenterol. 1990, 22, 33-35.

36. Mullady DK, Yadav D, Amann ST, O'Connell MR, Barmada MM, EltaGH, et al. Type of pain, painassociated complications, quality of life, disability and resource utilisation in chronic pancreatitis: aprospective cohort study. Gut 60(1):77-84, 2011. PMID: 21148579.

37. D Dominguez, K Kirkwood. Pathogenesis of pain in chronic pancreatitis. The Pancreapedia. Version 1.0, May 9, 2015.

38. DiMagno EP. A short, eclectic history of exocrine pancreatic insufficiency and chronic pancreatitis. Gastroenterology 1993; 104:1255-62.

39. S Hofmeyr, BL Warren. Serum lipase should be the laboratory test of choice for suspected acute pancreatitis. S Afr J Surg 2014;52(3):72-75. DOI:10.7196/SAJS.2003.

Abstract

References

Corresponding Author

Call For Paper Volume 12 Issue 12 December 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles

Search

Abstract

Call For Paper Volume 12 Issue 12 December 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles