Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India

Vallath Balakrishnan, Ambika Gopalakrishnan Unnikrishnan, Varghese Thomas, Gourdas Choudhuri, Peda Veeraraju, Shivram Prasad Singh, Pramod Garg, Cannore Ganesh Pai, Raveendranathan Nair Sobhana Devi, Deepak Bhasin, Venkataraman Jayanthi, Narayanan Premalatha, Ashok Chacko, Premashish Kar, Ramesh Roop Rai, Ramesh Rajan, Narayanan Subhalal, Rajiv Mehta, Sri Prakash Mishra, Manisha Dwivedi & 21 others Kattoor Ramakrishnan Nair Vinayakumar, Ashok Kumar Jain, Kalidas Biswas, Sunil Mathai, Jaison Varghese, Hariharan Ramesh, Thomas Alexander, Jacob Philip, Vigna Venugopal Raj, Ankarath Vinodkumar, Srikanth Mukevar, Prabha Sawant, Prem Nair, Harish Kumar, Surendran Sudhindran, Puneet Dhar, Othayil Vayoth Sudheer, Karimassery Ramaiyer Sundaram, Bailuru Vishwanath Tantri, Devinder Singh, Thekkayil Rajindra Nath

Research output: Contribution to journalArticle

91 Citations (Scopus)

Abstract

Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2%) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7%); the rest (n=11; 1.1%) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3%) and 189 (18.3%) subjects, respectively. Using well-defined criteria, only 39 (3.8%)cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0%). Four hundred and eighteen (40.5%) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8%) and biliary obstruction (8.2%). Pancreatic cancer occurred in 42 subjects (4.1%). Ultrasound detected calculi in 69.7%, ductal dilatation in 63.4% and atrophy in 27.3%. The majority of patients were on medical therapy (n=849; 82.2%); endotherapy and surgery accounted for the rest. About 50% percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.

Original languageEnglish
Pages (from-to)593-600
Number of pages8
JournalJournal of the Pancreas
Volume9
Issue number5
Publication statusPublished - 03-12-2008

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Chronic Pancreatitis
India
Prospective Studies
Pancreatitis
Alcoholic Pancreatitis
Manihot
Calculi
Pancreatic Neoplasms
Alcoholism
Atrophy
Dilatation
Diabetes Mellitus
Smoking
Alcohols
Outcome Assessment (Health Care)
Insulin
Pain
Therapeutics

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

Cite this

Balakrishnan, V., Unnikrishnan, A. G., Thomas, V., Choudhuri, G., Veeraraju, P., Singh, S. P., ... Nath, T. R. (2008). Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. Journal of the Pancreas, 9(5), 593-600.
Balakrishnan, Vallath ; Unnikrishnan, Ambika Gopalakrishnan ; Thomas, Varghese ; Choudhuri, Gourdas ; Veeraraju, Peda ; Singh, Shivram Prasad ; Garg, Pramod ; Pai, Cannore Ganesh ; Devi, Raveendranathan Nair Sobhana ; Bhasin, Deepak ; Jayanthi, Venkataraman ; Premalatha, Narayanan ; Chacko, Ashok ; Kar, Premashish ; Rai, Ramesh Roop ; Rajan, Ramesh ; Subhalal, Narayanan ; Mehta, Rajiv ; Mishra, Sri Prakash ; Dwivedi, Manisha ; Vinayakumar, Kattoor Ramakrishnan Nair ; Jain, Ashok Kumar ; Biswas, Kalidas ; Mathai, Sunil ; Varghese, Jaison ; Ramesh, Hariharan ; Alexander, Thomas ; Philip, Jacob ; Raj, Vigna Venugopal ; Vinodkumar, Ankarath ; Mukevar, Srikanth ; Sawant, Prabha ; Nair, Prem ; Kumar, Harish ; Sudhindran, Surendran ; Dhar, Puneet ; Sudheer, Othayil Vayoth ; Sundaram, Karimassery Ramaiyer ; Tantri, Bailuru Vishwanath ; Singh, Devinder ; Nath, Thekkayil Rajindra. / Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. In: Journal of the Pancreas. 2008 ; Vol. 9, No. 5. pp. 593-600.
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abstract = "Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2{\%}) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7{\%}); the rest (n=11; 1.1{\%}) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3{\%}) and 189 (18.3{\%}) subjects, respectively. Using well-defined criteria, only 39 (3.8{\%})cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0{\%}). Four hundred and eighteen (40.5{\%}) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8{\%}) and biliary obstruction (8.2{\%}). Pancreatic cancer occurred in 42 subjects (4.1{\%}). Ultrasound detected calculi in 69.7{\%}, ductal dilatation in 63.4{\%} and atrophy in 27.3{\%}. The majority of patients were on medical therapy (n=849; 82.2{\%}); endotherapy and surgery accounted for the rest. About 50{\%} percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.",
author = "Vallath Balakrishnan and Unnikrishnan, {Ambika Gopalakrishnan} and Varghese Thomas and Gourdas Choudhuri and Peda Veeraraju and Singh, {Shivram Prasad} and Pramod Garg and Pai, {Cannore Ganesh} and Devi, {Raveendranathan Nair Sobhana} and Deepak Bhasin and Venkataraman Jayanthi and Narayanan Premalatha and Ashok Chacko and Premashish Kar and Rai, {Ramesh Roop} and Ramesh Rajan and Narayanan Subhalal and Rajiv Mehta and Mishra, {Sri Prakash} and Manisha Dwivedi and Vinayakumar, {Kattoor Ramakrishnan Nair} and Jain, {Ashok Kumar} and Kalidas Biswas and Sunil Mathai and Jaison Varghese and Hariharan Ramesh and Thomas Alexander and Jacob Philip and Raj, {Vigna Venugopal} and Ankarath Vinodkumar and Srikanth Mukevar and Prabha Sawant and Prem Nair and Harish Kumar and Surendran Sudhindran and Puneet Dhar and Sudheer, {Othayil Vayoth} and Sundaram, {Karimassery Ramaiyer} and Tantri, {Bailuru Vishwanath} and Devinder Singh and Nath, {Thekkayil Rajindra}",
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Balakrishnan, V, Unnikrishnan, AG, Thomas, V, Choudhuri, G, Veeraraju, P, Singh, SP, Garg, P, Pai, CG, Devi, RNS, Bhasin, D, Jayanthi, V, Premalatha, N, Chacko, A, Kar, P, Rai, RR, Rajan, R, Subhalal, N, Mehta, R, Mishra, SP, Dwivedi, M, Vinayakumar, KRN, Jain, AK, Biswas, K, Mathai, S, Varghese, J, Ramesh, H, Alexander, T, Philip, J, Raj, VV, Vinodkumar, A, Mukevar, S, Sawant, P, Nair, P, Kumar, H, Sudhindran, S, Dhar, P, Sudheer, OV, Sundaram, KR, Tantri, BV, Singh, D & Nath, TR 2008, 'Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India', Journal of the Pancreas, vol. 9, no. 5, pp. 593-600.

Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. / Balakrishnan, Vallath; Unnikrishnan, Ambika Gopalakrishnan; Thomas, Varghese; Choudhuri, Gourdas; Veeraraju, Peda; Singh, Shivram Prasad; Garg, Pramod; Pai, Cannore Ganesh; Devi, Raveendranathan Nair Sobhana; Bhasin, Deepak; Jayanthi, Venkataraman; Premalatha, Narayanan; Chacko, Ashok; Kar, Premashish; Rai, Ramesh Roop; Rajan, Ramesh; Subhalal, Narayanan; Mehta, Rajiv; Mishra, Sri Prakash; Dwivedi, Manisha; Vinayakumar, Kattoor Ramakrishnan Nair; Jain, Ashok Kumar; Biswas, Kalidas; Mathai, Sunil; Varghese, Jaison; Ramesh, Hariharan; Alexander, Thomas; Philip, Jacob; Raj, Vigna Venugopal; Vinodkumar, Ankarath; Mukevar, Srikanth; Sawant, Prabha; Nair, Prem; Kumar, Harish; Sudhindran, Surendran; Dhar, Puneet; Sudheer, Othayil Vayoth; Sundaram, Karimassery Ramaiyer; Tantri, Bailuru Vishwanath; Singh, Devinder; Nath, Thekkayil Rajindra.

In: Journal of the Pancreas, Vol. 9, No. 5, 03.12.2008, p. 593-600.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India

AU - Balakrishnan, Vallath

AU - Unnikrishnan, Ambika Gopalakrishnan

AU - Thomas, Varghese

AU - Choudhuri, Gourdas

AU - Veeraraju, Peda

AU - Singh, Shivram Prasad

AU - Garg, Pramod

AU - Pai, Cannore Ganesh

AU - Devi, Raveendranathan Nair Sobhana

AU - Bhasin, Deepak

AU - Jayanthi, Venkataraman

AU - Premalatha, Narayanan

AU - Chacko, Ashok

AU - Kar, Premashish

AU - Rai, Ramesh Roop

AU - Rajan, Ramesh

AU - Subhalal, Narayanan

AU - Mehta, Rajiv

AU - Mishra, Sri Prakash

AU - Dwivedi, Manisha

AU - Vinayakumar, Kattoor Ramakrishnan Nair

AU - Jain, Ashok Kumar

AU - Biswas, Kalidas

AU - Mathai, Sunil

AU - Varghese, Jaison

AU - Ramesh, Hariharan

AU - Alexander, Thomas

AU - Philip, Jacob

AU - Raj, Vigna Venugopal

AU - Vinodkumar, Ankarath

AU - Mukevar, Srikanth

AU - Sawant, Prabha

AU - Nair, Prem

AU - Kumar, Harish

AU - Sudhindran, Surendran

AU - Dhar, Puneet

AU - Sudheer, Othayil Vayoth

AU - Sundaram, Karimassery Ramaiyer

AU - Tantri, Bailuru Vishwanath

AU - Singh, Devinder

AU - Nath, Thekkayil Rajindra

PY - 2008/12/3

Y1 - 2008/12/3

N2 - Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2%) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7%); the rest (n=11; 1.1%) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3%) and 189 (18.3%) subjects, respectively. Using well-defined criteria, only 39 (3.8%)cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0%). Four hundred and eighteen (40.5%) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8%) and biliary obstruction (8.2%). Pancreatic cancer occurred in 42 subjects (4.1%). Ultrasound detected calculi in 69.7%, ductal dilatation in 63.4% and atrophy in 27.3%. The majority of patients were on medical therapy (n=849; 82.2%); endotherapy and surgery accounted for the rest. About 50% percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.

AB - Context: Chronic pancreatitis is common in India. However, its risk factors are not clear. There is sparse data on the current prevalence of tropical pancreatitis in India. Objective: To undertake a prospective nationwide study of the risk factors and clinical profile of chronic pancreatitis. Setting: Thirty-two major centers from different regions of India contributed data on 1,086 patients to a common online website (www.ipans.org). Main outcome measures: Risk factors, clinical features complications and treatment of chronic pancreatitis. Results: Of the 1,086 subjects, complete data on risk factors were available for 1,033 subjects. Idiopathic pancreatitis was the most common form of pancreatitis (n=622; 60.2%) and alcoholic chronic pancreatitis accounted for about a third of the cases (n=400; 38.7%); the rest (n=11; 1.1%) had rare risk factors. Smoking and cassava intake were documented in 292 (28.3%) and 189 (18.3%) subjects, respectively. Using well-defined criteria, only 39 (3.8%)cases could be labeled as 'tropical pancreatitis'. Pain occurred in 971 patients (94.0%). Four hundred and eighteen (40.5%) subjects had diabetes mellitus. Of alcohol consumers, alcoholism and female gender were independent risk factors for diabetes in subjects with chronic pancreatitis (OR=1.48, P=0.003; and OR=1.75, P<0.001, respectively). The most common complications were pseudocysts (15.8%) and biliary obstruction (8.2%). Pancreatic cancer occurred in 42 subjects (4.1%). Ultrasound detected calculi in 69.7%, ductal dilatation in 63.4% and atrophy in 27.3%. The majority of patients were on medical therapy (n=849; 82.2%); endotherapy and surgery accounted for the rest. About 50% percent of the patients with diabetes required insulin (198/418). Conclusions: In this first nationwide prospective survey of chronic pancreatitis in India, idiopathic pancreatitis was the most common form, followed by alcoholic pancreatitis. The classical form of tropical chronic pancreatitis is becoming less common.

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VL - 9

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Balakrishnan V, Unnikrishnan AG, Thomas V, Choudhuri G, Veeraraju P, Singh SP et al. Chronic pancreatitis. A prospective nationwide study of 1,086 subjects from India. Journal of the Pancreas. 2008 Dec 3;9(5):593-600.