Malnutrition as a cause of chronic pancreatitis: Myth dispelled?
Apte, M. V., Pirola, R. C., & Wilson, J. S. (2008). Malnutrition as a cause of chronic pancreatitis: Myth dispelled? Journal of Gastroenterology and Hepatology, 23(9), 1312–1314. doi: 10.1111/j.1440-1746.2008.05542.x
A role for protein energy malnutrition in the etiopathogenesis of chronic pancreatitis was postulated several decades ago, based largely on studies of tropical pancreatitis (a chronic calcifying form of pancreatitis) occurring in non-alcoholics from areas where malnutrition is prevalent, such as India, South-East Asia and some parts of Africa.1 A typical patient with this condition presented at a relatively young age with severe abdominal pain, pancreatic calcification and diabetes and, in the majority of cases, belonged to the lower socioeconomic strata of society with its inherent problems of undernutrition. Furthermore, through most of the last century, alcoholic pancreatitis in Western countries was widely thought to be, at least partially, caused by the poor nutrition of heavy drinkers.2,3 Lack of adequate nutrition in alcoholics was thought to be due to: (i) displacement of essential dietary components by alcoholic beverages, which are high in energy value but contain negligible amounts of protein or other nutrients; and (ii) maldigestion and malabsorption of food secondary to the toxic effects of alcohol on gut mucosa and pancreas.