Digestive health centre

Just one measure of spirits increases risk of acute pancreatitis

9^th August 2011 - Drinking just one 40ml measure of spirits can increase the risk of an acute attack of pancreatitis, but wine or beer does not appear to have the same effect, according to a study published online by the British Journal of Surgery. (A standard British pub measure is 25ml, while a large measure is 35ml.)

The study suggests that there are constituents in spirits that are not present in wine and beer and that they can cause acute pancreatitis, either on their own or in combination with alcohol.

Researchers from the Karolinska Institute in Sweden followed 84,601 people from 46 to 84 years of age from the general population in Vastmanland and Uppsala for a median of ten years. During that time 513 developed acute pancreatitis.

"Our study revealed a steady increase between each measure of spirits a person drank on one occasion and the risk of having an acute attack of pancreatitis, starting at just under ten per cent for one 40ml drink," says lead author Dr Omid Sadr-Azodi.

52 per cent higher risk after four measures

For example, drinking 200ml of spirits - about eight regular pub measures - on a single occasion increased the risk of an acute episode by 52% and the risk then continued to increase at that rate for every five additional units consumed. However, drinking more than five 150ml glasses of wine or three pints of beer on one occasion did not increase the risk.

"We also discovered that the average monthly consumption of alcohol did not increase the risk. However, it is important to point out that most of the people included in our study drank alcohol within acceptable ranges, consuming one to two glasses a day,"  the authors noted.

Lower incidence when sales of spirits down

The authors were keen to investigate the effect that different types of alcohol had on acute pancreatitis after noticing that incidence rates declined in Sweden when sales of spirits declined, despite increased sales of wine and beer. A similar pattern was observed in Finland.

"When alcohol metabolises it induces oxidative stress and this in turn can lead to damaged pancreatic tissue," says Dr Sadr-Azodi. "However, research has shown that alcohol on its own is not sufficient to cause acute pancreatitis. Our study suggests that there are constituents in spirits that are not present in wine and beer and that they can cause acute pancreatitis, either on their own or in combination with alcohol."

Need to look at constituents

The authors are calling for more research into the association between increased consumption of spirits and acute pancreatitis, with a greater focus on constituents other than the alcohol.

Acute pancreatitis, or inflammation of the pancreas, is responsible for around 25,000 hospital admissions and 950 deaths each year in England. It is estimated that most hospitals will treat one or two people with acute pancreatitis every week. Alcohol consumption accounts for about a quarter of all cases of acute pancreatitis in England and gallstones for about half. Rates of acute pancreatitis have risen sharply in England over the past 40 years. This is thought to be because of a rise in alcohol use and in obesity, which is a risk factor for gallstones.