Abstract
Inflammatory bowel disease (IBD) is an idiopathic chronic and recurrent condition that comprises Crohn’s disease and ulcerative colitis. A pancreatic lesion is one of the extraintestinal lesions in patients with IBD. Acute pancreatitis is the representative manifestation, and various causes of pancreatitis have been reported, including those involving adverse effects of drug therapies such as 5-aminosalicylic acid and thiopurines, gall stones, gastrointestinal lesions on the duodenum, iatrogenic harm accompanying endoscopic procedures such as balloon endoscopy, and autoimmunity. Of these potential causes, autoimmune pancreatitis (AIP) is a relatively newly recognized disease and is being increasingly diagnosed in IBD. AIP cases can be divided into type 1 cases involving lymphocytes and IgG4-positive plasma cells, and type 2 cases primarily involving neutrophils; the majority of AIP cases complicating IBD are type 2. The association between IBD and chronic pancreatitis, exocrine pancreatic insufficiency, pancreatic cancer, etc. has also been suggested; however, studies with high-quality level evidence are limited, and much remains unknown. In this review, we provide an overview of the etiology of pancreatic manifestation in patients with IBD.
Highlights
Inflammatory bowel disease (IBD) is an idiopathic chronic and recurrent condition that comprises Crohn’s disease (CD) and ulcerative colitis (UC), and the number of affected patients has risen sharply in recent years in Europe, the United States of America, and Japan [1]
With regard to pancreatic manifestations accompanied by IBD, in 1950, Ball et al [9] reported on pancreatic manifestations accompanied by UC observed in autopsies for the first time, and in 1956, in an investigation involving autopsies, Chapin et al [10] reported that histological changes in the pancreas associated with regional enteritis were primarily interlobar and periductal fibrosis and swelling of the acinar cells
Pancreatic manifestations associated with IBD are one set of extraintestinal manifestations, and controlling their progression is extremely important because poor control affects the treatment of intestinal lesions
Summary
Inflammatory bowel disease (IBD) is an idiopathic chronic and recurrent condition that comprises Crohn’s disease (CD) and ulcerative colitis (UC), and the number of affected patients has risen sharply in recent years in Europe, the United States of America, and Japan [1]. IBD is a systemic disease that often manifests extraintestinally and has an incidence rate of 6–47% [3]. Typical extraintestinal manifestations of IBD include dermatologic, musculoskeletal, ocular, oral, pulmonary, hepatobiliary, and pancreatic lesions [4,5,6,7,8]. The majority of pancreatic manifestations accompanied by IBD are increased pancreatic enzyme levels and pancreatitis. We provide an overview of the etiology and treatment of pancreatitis in patients with IBD
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