Risk of pancreatitis in patients with inflammatory bowel disease - a meta-analysis

INTRODUCTION: Patients with inflammatory bowel disease (IBD), Including Crohn's disease (CD) and ulcerative colitis (UC), are believed to be at increased risk of pancreatitis. The objective of the present study was to investigate the association between IBD and risk of pancreatitis in a systematic review and meta-analysis. METHODS: We conducted a systematic literature search in the PubMed and Embase databases. Data were extracted using predefined data fields, and risk of bias was assessed using the Risk of Bias Assessment tool for Non-randomized Studies. Random-effects meta-analyses were conducted. RESULTS: Four studies with acute pancreatitis as outcome met the eligibility criteria. The overall estimated risk ratio revealed an increased risk for acute pancreatitis in patients with IBD of 2.78 (95% confidence interval (CI): 2.40-3.22). The risk ratio was increased for both CD and UC, with estimated risk ratios of 3.62 (95% CI: 2.99-4.38) and 2.24 (95% CI: 1.85- 2.71), respectively. No studies meeting the eligibility criteria had chronic pancreatitis as outcome. CONCLUSIONS: The risk of acute pancreatitis is increased in patients with IBD and higher tor patients with CD. Due to the observational design of the studies included in our meta- analysis, the mechanisms underlying the increased risk of pancreatitis are unknown and remain to be investigated. Studies of the risk of chronic pancreatitis among patients with IBD are warranted.