Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis.

CONTEXT: Epidemiologic studies have suggested an association between alcohol consumption and pancreatitis, although the exact dose-response relationship is unknown. It also remains uncertain whether a threshold effect exists. OBJECTIVE: To conduct a systematic review and meta-analysis of epidemiologic studies on the association between alcohol consumption and the risk of pancreatitis. METHODS: We searched Ovid MEDLINE, EMBASE, CINAHL, Web of Science, ETOH and AIM. Studies were included if they reported quantifiable information on risk and related confidence intervals with respect to at least three different levels of alcohol intake. RESULTS: Six studies, including 146,517 individuals with 1,671 cases of pancreatitis, met the inclusion criteria. We found a monotonic and approximately exponential dose-response relationship between average volume of alcohol consumption and pancreatitis. However, in a categorical analysis the lower drinking categories were not significantly elevated, with an apparent threshold of 4 drinks daily. CONCLUSIONS: As the available evidence also indicates that the relationship is biologically plausible, these results support the existence of a link between alcohol consumption and the risk of pancreatitis.