Steroid Use and the Risk of Acute Pancreatitis in Inflammatory Bowel Disease: A Retrospective Study In Kashmiri population

Aims This study aimed to explore the link between steroid use and the development of acute pancreatitis (AP) in patients with inflammatory bowel disease (IBD) from the Kashmiri region. We wanted to understand whether certain factors, like the dose or duration of steroid treatment, increase the risk of pancreatitis in these patients.

Methods We conducted a retrospective analysis of 200 IBD patients (either with Crohn’s disease or ulcerative colitis) who were treated with corticosteroids for flare-ups at Divisional Headquarters Teaching Hospital Mirpur Azad Jammu and Kashmir between jan 2021and December 2023. Acute pancreatitis was diagnosed based on typical symptoms, elevated amylase and lipase levels, and imaging results. The patients were divided into two groups: those who developed acute pancreatitis (25 patients) and those who did not (175 patients). We gathered data on patient characteristics, including IBD subtype, steroid dosage, duration of therapy, other health conditions (such as gallstones), and any additional medications they were taking. We then analyzed which factors were associated with a higher risk of acute pancreatitis [1] [2].

Results Out of the 200 patients, 25 (12.5%) developed acute pancreatitis during their treatment with steroids. We found that the risk of pancreatitis was higher in patients who were given higher doses of steroids (40 mg/day or more) and who used steroids for longer periods (more than 4 weeks). Among patients on higher doses, 18% (15 patients) developed acute pancreatitis, compared to only 5% (10 patients) in those receiving lower doses or shorter courses of treatment. Our analysis identified three key risk factors for pancreatitis:

1. High-dose steroid therapy (≥ 40 mg/day)

2. Prolonged steroid use (≥ 4 weeks)

3. A history of gallstones

We did not find any significant difference in pancreatitis risk between patients with Crohn’s disease and those with ulcerative colitis.

Conclusions Our findings revealed that high-dose and long-term steroid therapy in IBD patients from the Kashmiri population is linked to a higher risk of developing acute pancreatitis, especially when combined with other risk factors like gallstones. These results highlight the importance of closely monitoring IBD patients on steroids, particularly those who are on high doses or extended treatments. Further research, including prospective studies, is needed to confirm these findings and help develop safer guidelines for steroid use in IBD management.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Gaisano HY, Gorelick FS.. New insights into the mechanisms of pancreatitis. Gastroenterology. 2009; 136 (7): 2040-204419379751
• 2 Frossard JL, Steer ML, Pastor CM.. Acute pancreatitis. Lancet. 2008; 371 (9607): 143-15218191686