Microscopic colitis and the risk of acute pancreatitis

In a nationwide Swedish study of more than 12,000 patients with microscopic colitis (MC), researchers from Sahlgrenska University Hospital and Karolinska Institutet found an increased risk of acute pancreatitis compared to the general population. The study has been published in the American Journal of Gastroenterology.

MC is one of the most recently recognized inflammatory conditions of the large intestine. As such, knowledge of the association to other disorders is limited. Earlier studies have suggested increased risks of acute pancreatitis, a potentially fatal disorder, in patients with inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, but data on patients with MC have, until now, been lacking.

In a nationwide Swedish study of more than 12,000 patients with MC, researchers found a 57% increase in the risk of acute pancreatitis in patients with MC compared to individuals from the general population. Data on MC were retrieved from the Nationwide histopathology cohort ESPRESSO.

The team also found that there was no increase in the risk of acute pancreatitis caused by gallstones. Followingly, the increased risk was driven by the stronger association to acute pancreatitis unrelated to gallstones.

"We feel our work is of importance since it is the first study to date to address the association between MC and acute pancreatitis," says lead author Dr. David Bergman, M.D, Ph.D. at the Department of Medical Epidemiology and Biostatistics. "Our findings add to the knowledge of associated inflammatory conditions in MC and underline the importance to provide advice and care aimed at minimizing the risk of acute pancreatitis in MC."

Similar results for men and women

The researchers also examined whether the association differed for men and women or by age below or above 50. The results for the different groups, however, were similar.

"More and more people are diagnosed with MC and asking for information about comorbidity. We are happy to be able to provide such information" says the last author Professor Jonas F. Ludvigsson, pediatrician at Örebro University Hospital, and Professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet.

"Having access to longitudinal data on patients with MC, matched controls but also siblings to patients with MC allows us to calculate risks of severe complications and also to move the field forward by taking confounding from shared familial risk factors into account," adds Ludvigsson.