Modifications of pure human pancreatic juice induced by chronic alcohol consumption

Abstract

Pure pancreatic juice has been collected from 25 humans by endoscopic retrograde catheterization of the papilla. Nine did not present with digestive diseases and their mean daily alcohol consumption had never exceeded 40 g (nonalcoholic controls). Sixteen drank more than 100 g alcohol per day for at least 5 years previously (alcoholic patients). Five of those presented with chronic pancreatitis and 11 were apparently normal (alcoholic controls). Juice was collected in 1-min fractions for 20 min. 0.5 CU/kg secretin was injected at the beginning and 3 CHR U/kg cholecystokinin-pancreozymin at the 10th min. Protein concentration was significantly greater in alcoholic patients than in nonalcoholic controls in the samples following both secretin and cholecystokinin-pancreozymin injections, and the highest observed protein concentration was significantly greater in alcoholic controls than in nonalcoholic controls. When it had returned to resting values after hormonal injections, protein concentration was significantly higher in alcoholic chronic pancreatitis patients than in alcoholic controls in six samples, and in two similar samples it was higher in alcoholic chronic pancreatitis patients than in nonalcoholic controls. Protein output was not significantly different in alcoholic controls than in nonalcoholic controls. Bicarbonate concentration was significantly lower in alcoholic patients than in nonalcoholic controls in two samples following secretin injection. Volume was similar in alcoholic controls and nonalcoholic controls, but lower in alcoholic chronic pancreatitis patients than in alcoholic controls in three samples. These results substantiate the assumption already put forward of a hypersecretion of protein not compensated for by a hypersecretion of water and bicarbonate as the origin of alcoholic pancreatitis.