Background: Alcohol is one of the etiological factors of chronic pancreatitis and there is
evidence that acute pancreatitis is the first episode of preexisting chronic pancreatitis and is sometimes
not evident from a clinical point of view. The diagnosis of acute pancreatitis is based on the
presence of abdominal pain, serum increase of pancreatic enzymes or their presence in urine and/or
the presence of alterations of the pancreas imaging. Aims: To revise actual knowledge on the relationship
between alcohol use and pancreatic diseases benign as well as malignant. Results: In occasional
drinkers, levels of serum amylase were found to be abnormally high in approximately 13% of subjects,
while pancreatic isoamylase and lipase were found to be abnormally high in serum in only 2%.
The reason might be related to the fact that alcohol can affect the salivary glands. In chronic alcoholics without abdominal
pain, amylase and lipase in serum are elevated in 14% of subjects and, in patients with alcoholic acute pancreatitis, pancreatic
amylase and isoamylase are elevated in 94% of cases and lipase is generally more sensitive (100% of cases). Conclusions:
Chronic abuse of alcohol, but not occasional alcoholic intoxication, causes pancreatic damage. Regarding pancreatic
neoplasms, the role of alcohol is under debate in ductal pancreatic adenocarcinoma as well as in pancreatic neuroendocrine
tumors. Few relevant patents are also described in this review.
Keywords: Acute pancreatitis, alcohol, chronic pancreatitis, inflammation, pain, pancreatic cancer, recurrent pancreatitis.
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